腹腔镜胆囊切除术后肝动脉或胆囊动脉假性动脉瘤：病因发病机制、临床表现、诊断及治疗的文献综述
Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy: Literature review of aetiopathogenesis, presentation, diagnosis and management.
作者信息
Machado Norman O, Al-Zadjali Adil, Kakaria Anupam K, Younus Shahzad, Rahim Mohamed A, Al-Sukaiti Rashid
机构信息
Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman.
出版信息
Sultan Qaboos Univ Med J. 2017 May;17(2):e135-e146. doi: 10.18295/squmj.2016.17.02.002. Epub 2017 Jun 20.
Pseudoaneurysms (PSAs) of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy (LC). Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation (TAE) is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation (85.1%) and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases (88.1%), followed by the cystic artery (7.9%) and a combination of both (4.0%). Most cases were managed with TAE (72.3%), with a 94.5% success rate. The overall mortality rate was 2.0%.
肝动脉和/或胆囊动脉假性动脉瘤（PSA）是腹腔镜胆囊切除术（LC）后一种罕见的并发症。一般来说，PSA病例在手术后数周会出现胆道出血。经动脉栓塞术（TAE）被认为是最佳的治疗方法。我们报告一名70岁女性，2016年在阿曼马斯喀特的苏丹卡布斯大学医院就诊，她在另一家医院接受LC手术后两周出现大量腹腔积血。她通过使用弹簧圈TAE成功得到治疗。广泛的文献回顾显示，LC手术后有101例肝动脉或胆囊动脉PSA病例。胆道出血是主要表现（85.1%），术后出现症状的平均时间为36天。大多数病例累及肝动脉（88.1%），其次是胆囊动脉（7.9%）以及两者合并（4.0%）。大多数病例采用TAE治疗（72.3%），成功率为94.5%。总死亡率为2.0%。
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