Hepatic or cystic artery pseudoaneurysms following a laparoscopic cholecystectomy : literature review of aetiopathogenesis, presentation, diagnosis and management

Abstract EN

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%.