PDF(Pubmed)
Abstract：
Pseudoaneurysms of the right hepatic artery following cholecystectomy are caused by either vascular damage or erosion after a biliary leak. Symptoms often include haemobilia, melena, vomiting, jaundice, and hemodynamic failure due to aneurysm rupture. The ideal treatment is arterial embolization or, in rare cases, stenting. We present a case of pseudoaneurysm of the right hepatic artery post-laparoscopic cholecystectomy. The patient presented with abdominal pain, vomiting, and hemodynamic failure on postoperative day 45. Magnetic resonance imaging (MRI) showed a large hematoma and a pseudoaneurysm of the right hepatic artery. A laparotomy was performed, and a large hematoma was found and evacuated. After the pringle maneuver, the pseudoaneurysm was resected. The right hepatic artery was ligated with clips, and a sub-hepatic drain was placed. The non-availability of emergency embolization forced surgical closure of the right hepatic artery, which is still the first-line treatment for such cases. Injury of the right hepatic artery is a rare complication, often overlooked by surgeons, and requires early diagnosis. Surgical treatment is reserved for cases of embolization failure or hemodynamic instability.
摘要：
胆囊切除术后右肝动脉的假性动脉瘤是由胆漏后的血管损伤或糜烂引起的。症状通常包括胆道出血，Melena,呕吐,黄疸,动脉瘤破裂引起的血流动力学衰竭。理想的治疗方法是动脉栓塞或,在极少数情况下，支架。我们介绍了腹腔镜胆囊切除术后右肝动脉假性动脉瘤的病例。病人出现腹痛,呕吐,术后第45天血流动力学衰竭。磁共振成像（MRI）显示右肝动脉有大量血肿和假性动脉瘤。进行了剖腹手术,发现并疏散了一个大血肿。在Pringle机动之后，手术切除了假性动脉瘤.右肝动脉用夹子结扎,并放置了肝下引流管。紧急栓塞的不可用迫使右肝动脉手术闭合，这仍然是这种情况的一线治疗方法。肝右动脉损伤是一种罕见的并发症，经常被外科医生忽视，需要早期诊断.手术治疗保留用于栓塞失败或血流动力学不稳定的情况。
