Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report
Abstract Background Iatrogenic hepatic artery pseudoaneurysm is a rare complication following laparoscopic cholecystectomy. Trans-arterial embolization (TAE) is an effective way to control bleeding after a ruptured aneurysm. But uncommonly, rebleeding may occur which will require a second embolizati...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-021-01438-2 |
| _version_ | 1811332180733853696 |
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| author | Ted Hsiung Tsung-Shih Lee Yueh-Lin Lee Ting-Shuo Huang Chih-Yuan Wang |
| author_facet | Ted Hsiung Tsung-Shih Lee Yueh-Lin Lee Ting-Shuo Huang Chih-Yuan Wang |
| author_sort | Ted Hsiung |
| collection | DOAJ |
| description | Abstract Background Iatrogenic hepatic artery pseudoaneurysm is a rare complication following laparoscopic cholecystectomy. Trans-arterial embolization (TAE) is an effective way to control bleeding after a ruptured aneurysm. But uncommonly, rebleeding may occur which will require a second embolization or even laparotomy. Case presentation We report a case of a 45-year-old woman who underwent robotic-assisted cholecystectomy after the diagnosis of type II Mirizzi syndrome. During the operation, the anterior branch of the right hepatic artery was damaged and Hem-o-lok clips were applied to control the bleeding. The postoperative course was smooth, and the patient was discharged 6 days after the procedure. However, one week after hospital discharge, she presented to the emergency department with right upper abdominal tenderness, melena, and jaundice. After examination, the computed tomography angiography (CTA) revealed a 3 cm pseudoaneurysm at the distal stump of the right hepatic artery anterior branch. TAE with gelfoam material was performed. Three days later, the patient had an acute onset of abdominal pain. A recurrent pseudoaneurysm was found at the same location. She underwent TAE again but this time with a steel coil. No further complication was noted, and she was discharged one week later. Conclusions Even with the assistance of modern technologies such as the robotic surgery system, one should still take extra caution while handling the vessels. Also, embolization of the pseudoaneurysm with steel coils may be suitable for preventing recurrence. |
| first_indexed | 2024-04-13T16:32:57Z |
| format | Article |
| id | doaj.art-f9d69603d4814fbebdb7ca6a424c3b78 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-13T16:32:57Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-f9d69603d4814fbebdb7ca6a424c3b782022-12-22T02:39:31ZengBMCBMC Surgery1471-24822022-03-012211510.1186/s12893-021-01438-2Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case reportTed Hsiung0Tsung-Shih Lee1Yueh-Lin Lee2Ting-Shuo Huang3Chih-Yuan Wang4Department of General Surgery, Keelung Chang Gung Memorial HospitalDivision of Hepato-gastroenterology, Keelung Chang Gung Memorial HospitalDepartment of Radiology, Keelung Chang Gung Memorial HospitalDepartment of General Surgery, Keelung Chang Gung Memorial HospitalDepartment of General Surgery, Keelung Chang Gung Memorial HospitalAbstract Background Iatrogenic hepatic artery pseudoaneurysm is a rare complication following laparoscopic cholecystectomy. Trans-arterial embolization (TAE) is an effective way to control bleeding after a ruptured aneurysm. But uncommonly, rebleeding may occur which will require a second embolization or even laparotomy. Case presentation We report a case of a 45-year-old woman who underwent robotic-assisted cholecystectomy after the diagnosis of type II Mirizzi syndrome. During the operation, the anterior branch of the right hepatic artery was damaged and Hem-o-lok clips were applied to control the bleeding. The postoperative course was smooth, and the patient was discharged 6 days after the procedure. However, one week after hospital discharge, she presented to the emergency department with right upper abdominal tenderness, melena, and jaundice. After examination, the computed tomography angiography (CTA) revealed a 3 cm pseudoaneurysm at the distal stump of the right hepatic artery anterior branch. TAE with gelfoam material was performed. Three days later, the patient had an acute onset of abdominal pain. A recurrent pseudoaneurysm was found at the same location. She underwent TAE again but this time with a steel coil. No further complication was noted, and she was discharged one week later. Conclusions Even with the assistance of modern technologies such as the robotic surgery system, one should still take extra caution while handling the vessels. Also, embolization of the pseudoaneurysm with steel coils may be suitable for preventing recurrence.https://doi.org/10.1186/s12893-021-01438-2Iatrogenic hepatic artery pseudoaneurysmRobotic-assisted surgeryMirizzi syndromeCase report |
| spellingShingle | Ted Hsiung Tsung-Shih Lee Yueh-Lin Lee Ting-Shuo Huang Chih-Yuan Wang Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report BMC Surgery Iatrogenic hepatic artery pseudoaneurysm Robotic-assisted surgery Mirizzi syndrome Case report |
| title | Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report |
| title_full | Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report |
| title_fullStr | Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report |
| title_full_unstemmed | Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report |
| title_short | Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report |
| title_sort | recurrent right hepatic artery pseudoaneurysm after robotic assisted cholecystectomy in a patient with mirizzi syndrome a case report |
| topic | Iatrogenic hepatic artery pseudoaneurysm Robotic-assisted surgery Mirizzi syndrome Case report |
| url | https://doi.org/10.1186/s12893-021-01438-2 |
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