PDF(Pubmed)
Abstract：
Gallstone-related diseases like cholelithiasis contribute significantly to global morbidity and mortality. Laparoscopic cholecystectomy (LC) is the gold standard for gallbladder removal but is associated with rare but severe complications, including hepatic artery pseudoaneurysms (PAs). A 72-year-old female presented with acute abdominal pain and upper gastrointestinal bleeding following a recent LC. Laboratory studies confirmed anemia with a hemoglobin level of 10 g/dL. Liver function tests were deranged, showing elevated alanine aminotransferase (ALT) at 209 U/L, aspartate aminotransferase (AST) at 472 U/L, total bilirubin levels at 3.29 mg/dL, and direct bilirubin levels at 2.7 mg/dL. A contrast-enhanced computed tomography scan revealed a PA adjacent to the right hepatic artery. Given the strong suspicion of a hepatic PA as the source of her symptoms, an endovascular stent was placed by an interventional radiologist. Post-procedure, the patient showed a favorable clinical course with cessation of symptoms and was discharged after eight days. This case emphasizes the importance of early identification of hepatic artery PAs following LC, a potentially life-threatening complication. It also suggests that endovascular stent placement can be an effective alternative to traditional transarterial embolization for managing these PAs. Additional research is needed to evaluate the long-term effectiveness and safety of these two methods in comparison.
摘要：
胆石症等胆结石相关疾病对全球发病率和死亡率有显著影响。腹腔镜胆囊切除术（LC）是胆囊切除术的金标准，但与罕见但严重的并发症有关。包括肝动脉假性动脉瘤（PAs）。一名72岁的女性在最近的LC后出现急性腹痛和上消化道出血。实验室研究证实了血红蛋白水平为10g/dL的贫血。肝功能测试混乱，在209U/L时显示丙氨酸转氨酶（ALT）升高，天门冬氨酸氨基转移酶(AST)为472U/L，总胆红素水平为3.29mg/dL，和直接胆红素水平为2.7mg/dL。对比增强的计算机断层扫描显示，右肝动脉附近有PA。鉴于强烈怀疑肝脏PA是她症状的根源，介入放射科医师放置了血管内支架.手术后,患者表现出良好的临床过程，症状消失，八天后出院。此病例强调了早期识别LC后肝动脉PAs的重要性，可能危及生命的并发症.这也表明血管内支架放置可以是传统的经动脉栓塞治疗这些PA的有效替代方法。需要更多的研究来评估这两种方法的长期有效性和安全性。
