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腹腔镜胆囊切除术后右肝动脉假性动脉瘤:一种采用弹簧圈栓塞治疗的罕见并发症

Right Hepatic Artery Pseudoaneurysm Following Laparoscopic Cholecystectomy: A Rare Complication Treated With Coil Embolization.

作者信息

Babbar Vishal, Biswas Ronit, Kumar Aneesh, Kumari Sweta, Pratap Arvind, Singh Pramod K, Srivastava Vivek, Ansari Mumtaz A

机构信息

Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.

Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.

出版信息

Cureus. 2025 Jul 31;17(7):e89125. doi: 10.7759/cureus.89125. eCollection 2025 Jul.

Abstract

Hepatic artery pseudoaneurysm (HAPA) is an uncommon but potentially life-threatening vascular complication following laparoscopic cholecystectomy, often presenting days to weeks postoperatively. We describe the case of a 34-year-old female patient who presented 45 days following surgery with recurring hematemesis, melena, abdominal pain, and jaundice. Ultrasonography with colour Doppler suggested a vascular lesion near the porta hepatis, and triple-phase CT angiography confirmed a right hepatic artery (RHA) pseudoaneurysm leading to intrahepatic biliary radical dilatation (IHBRD). The patient underwent successful coil embolization, leading to full recovery without complications. HAPA should be considered in post-cholecystectomy patients who exhibit upper gastrointestinal (GI) hemorrhage or hemobilia. Early imaging diagnosis using Doppler ultrasound and CT angiography is imperative for timely intervention. Coil embolization provides a minimally invasive, effective alternative to open surgical repair, reducing associated morbidity and mortality. This case underscores the importance of prompt recognition and endovascular management of vascular complications following biliary surgery to prevent fatal outcomes.

摘要

肝动脉假性动脉瘤(HAPA)是腹腔镜胆囊切除术后一种罕见但可能危及生命的血管并发症,通常在术后数天至数周出现。我们报告一例34岁女性患者,术后45天出现反复呕血、黑便、腹痛和黄疸。彩色多普勒超声提示肝门附近有血管病变,三相CT血管造影证实右肝动脉(RHA)假性动脉瘤导致肝内胆管扩张(IHBRD)。患者成功接受了弹簧圈栓塞治疗,完全康复且无并发症。对于出现上消化道(GI)出血或胆道出血的胆囊切除术后患者,应考虑HAPA。使用多普勒超声和CT血管造影进行早期影像学诊断对于及时干预至关重要。弹簧圈栓塞为开放性手术修复提供了一种微创、有效的替代方法,可降低相关的发病率和死亡率。该病例强调了胆道手术后及时识别和血管内治疗血管并发症以预防致命后果的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fac5/12398275/260ce7693359/cureus-0017-00000089125-i01.jpg

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