Lampropoulos Charalampos, Markopoulos George, Tsochatzis Stylianos, Bellou Aggeliki, Amanatidis Theofilos, Kehagias Dimitrios, Papadopoulos George, Kehagias Ioannis
Department of Surgery, General Hospital of Ilia 'Andreas Papandreou', Pyrgos, Greece.
Department of Surgery, Florina General Hospital, Florina, Greece.
J Minim Access Surg. 2021 Oct-Dec;17(4):450-457. doi: 10.4103/jmas.JMAS_164_20.
Laparoscopic cholecystectomy (LC) has been associated with an increase in the incidence of biliary and vascular injuries. Pseudoaneurysms (PAs) following LC are rare life-threatening events with limited available experience regarding diagnosis and treatment.
An extensive review of literature during a 26-year period (1994-2020) using MEDLINE database and Google Scholar academic search engine revealed 134 patients with at least one symptomatic PA following LC.
Nearly.
81% of patients with PAs become symptomatic during the first 8 weeks following LC. The most common symptoms were gastrointestinal bleeding (74%) and abdominal pain (61%). In 28% of cases, there was a concomitant bile duct injury or leak from the cystic duct stump, whereas in about one-third of cases, PAs presented following an uneventful LC. The most common involved arteries were the right hepatic artery (70%), the cystic artery (19%) or both of them (3%). Trans-arterial embolisation was the favoured first-line treatment with a success rate of 83%. During a median follow-up of 9 months, the mortality rate was 7%.
Clinicians should be aware of the PA occurrence following LC. Prompt diagnosis and treatment are essential.
腹腔镜胆囊切除术（LC）与胆管和血管损伤发生率的增加有关。LC术后假性动脉瘤（PA）是罕见的危及生命的事件，关于其诊断和治疗的可用经验有限。
使用MEDLINE数据库和谷歌学术搜索引擎对26年期间（1994 - 2020年）的文献进行广泛检索，发现134例LC术后至少有一个有症状PA的患者。
几乎。
81%的PA患者在LC术后的前8周内出现症状。最常见的症状是胃肠道出血（74%）和腹痛（61%）。在28%的病例中，伴有胆管损伤或胆囊管残端渗漏，而在约三分之一的病例中，PA在LC手术顺利后出现。最常受累的动脉是右肝动脉（70%）、胆囊动脉（19%）或两者均受累（3%）。经动脉栓塞是首选的一线治疗方法，成功率为83%。在中位随访9个月期间，死亡率为7%。
临床医生应意识到LC术后PA的发生。及时诊断和治疗至关重要。
