Recurrent hemobilia after laparoscopic cholecystectomy

Area of Science:

• Hepatobiliary Surgery
• Vascular Interventions
• Gastroenterology

Background:

• Laparoscopic cholecystectomy is a common procedure.
• Vascular complications, such as hepatic artery aneurysm, are rare but serious.
• Hemobilia can occur post-operatively, necessitating prompt diagnosis and management.

Observation:

• A patient developed hemobilia one month following laparoscopic cholecystectomy.
• The cause was identified as an aneurysm in the right branch of the hepatic artery.
• Initial treatment involved selective arterial embolization.

Findings:

• The initial embolization was unsuccessful, leading to recurrent bleeding after 28 days.
• A second embolization procedure using platinum coils successfully controlled the bleeding.
• The case highlights the potential for delayed vascular complications after cholecystectomy.

Implications:

• This case underscores the importance of considering vascular etiologies in post-cholecystectomy hemobilia.
• Selective arterial embolization is a viable treatment option for hepatic artery aneurysms.
• Further research into the mechanisms of aneurysm formation post-cholecystectomy may improve preventative strategies.