Skip to main content
SpringerLink
Log in

Hemobilia and cystic artery stump pseudoaneurysm associated with liver abscess after a laparoscopic cholecystectomy: Report of a case

  • Case Report
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

A 63-year-old woman was admitted for cholecystitis and underwent a laparoscopic cholecystectomy (LC). She experienced abdominal pain and hemobilia 11 days after the LC. Angiography was performed but it did not show any source of bleeding. Thereafter, at 27 days after LC, a repeat angiogram was performed which revealed a pseudoaneurysm (PA) arising from a cystic artery stump and an embolized PA sack. However, another PA arising from near the embolized PA and liver abscess was observed 4 days after embolization. The arterial collateral flow was evaluated by endovascular balloon occlusion of the right hepatic artery and it was embolized proximal and distal to the bleeding point. The embolization of the partial hepatic artery was effective for PA when packing the PA sack proved to be insufficient. In patients with liver cirrhosis or liver abscess who require an adequate arterial liver flow, it is important to evaluate the collateral arterial flow before hepatic artery embolization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 1993;165:9–14.

    Article  PubMed  CAS  Google Scholar 

  2. Nicholson T, Travis S, Ettles D, Dyet J, Sedman P, Wedgewood K, et al. Hepatic artery angiography and embolization for hemobilia following laparoscopic cholecystectomy. Cardiovasc Intervent Radiol 1999;22:20–24.

    Article  PubMed  CAS  Google Scholar 

  3. Madanur MA, Battula N, Sethi H, Deshpande R, Heaton N, Rela M. Pseudoaneurysm following laparoscopic cholecystectomy. Hepatobiliary Pancreat Dis Int 2007;6:294–298.

    PubMed  Google Scholar 

  4. Genyk YS, Keller FS, Halpern NB. Hepatic artery pseudoaneurysm and hemobilia following laser laparoscopic cholecystectomy. A case report. Surg Endosc 1994;8:201–204.

    Article  PubMed  CAS  Google Scholar 

  5. Bergey E, Einstein DM, Herts BR. Cystic artery pseudoaneurysm as a complication of laparoscopic cholecystectomy. Abdom Imaging 1995;20:75–77.

    Article  PubMed  CAS  Google Scholar 

  6. Siablis D, Tepetes K, Vasiou K, Karnabatidis D, Perifanos S, Tzorakoleftherakis E. Hepatic artery pseudoaneurysm following laparoscopic cholecystectomy: transcatheter intraarterial embolization. Hepatogastroenterology 1996;43:1343–1346.

    PubMed  CAS  Google Scholar 

  7. Ibrarullah M, Singh B, Mehrotra P, Kaushik SP. Right hepatic artery pseudoaneurysm after laparoscopic cholecystectomy. Am J Gastroenterol 1997;92:528–529.

    PubMed  CAS  Google Scholar 

  8. Balsara KP, Dubash C, Shah CR. Pseudoaneurysm of the hepatic artery along with common bile duct injury following laparoscopic cholecystectomy. A report of two cases. Surg Endosc 1998;12:276–277.

    Article  PubMed  CAS  Google Scholar 

  9. Saldinger PF, Wang JY, Boyd C, Lang E. Cystic artery stump pseudoaneurysm following laparoscopic cholecystectomy. Surgery 2002;131:585–586.

    Article  PubMed  Google Scholar 

  10. Bulut T, Yamaner S, Bugra D, Akyuz A, Acarli K, Poyanli A. False aneurysm of the hepatic artery after laparoscopic cholecystectomy. Acta Chir Belg 2002;102:459–463.

    PubMed  CAS  Google Scholar 

  11. Yahchouchy-Chouillard E, Limot O, Ghiles E, Etienne JC, De Baer T, Picone O, et al. Embolization for right hepatic artery pseudoaneurysm following laparoscopic cholecystectomy. Aust NZ J Surg 2003;73:82–84.

    Article  Google Scholar 

  12. Journe S, De Simone P, Laureys M, Le Moine O, Gelin M, Closset J. Right hepatic artery pseudoaneurysm and cystic duct leak after laparoscopic cholecystectomy. Surg Endosc 2004;18:554–556.

    Article  PubMed  CAS  Google Scholar 

  13. Mays ET, Wheeler CS. Demonstration of collateral arterial flow after interruption of hepatic arteries in man. N Eng J Med 1974;220:93–96.

    Google Scholar 

  14. Singh CS, Giri K, Gupta R, Aladdin M, Sawhney H. Successful management of hepatic artery pseudoaneurysm complicating chronic pancreatitis by stenting. World J Gastroenterol 2006;12:5733–5734.

    PubMed  Google Scholar 

  15. Kaw LL Jr, Saeed M, Brunson M, Delaria GA, Dilley RB. Use of a stent graft for bleeding hepatic artery pseudoaneurysm following pancreaticoduodenectomy. Asian J Surg 2006;29:283–286.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Kyoto Prefectural University of Medicine, 1035 Rokken-machi, Kamigyo-ku, Kyoto, 602-8319, Japan

    Yuen Nakase, Tsuyoshi Takagi, Kanehisa Fukumoto & Takuya Miyagaki

  2. Department of Internal Medicine, Nishijin Hospital, Kyoto Prefectural University of Medicine, 1035 Rokken-machi, Kamigyo-ku, Kyoto, 602-8319, Japan

    Kyoichi Kassai & Kenji Itani

  3. Department of Radiology, Kyoto Prefectural University of Medicine, 1035 Rokken-machi, Kamigyo-ku, Kyoto, 602-8319, Japan

    Takuji Yamagami

Authors
  1. Yuen Nakase
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tsuyoshi Takagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kanehisa Fukumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyoichi Kassai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takuji Yamagami
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kenji Itani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takuya Miyagaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakase, Y., Takagi, T., Fukumoto, K. et al. Hemobilia and cystic artery stump pseudoaneurysm associated with liver abscess after a laparoscopic cholecystectomy: Report of a case. Surg Today 38, 567–571 (2008). https://doi.org/10.1007/s00595-007-3663-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-007-3663-9

Key words

Search

Navigation