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Vascular emergencies in cholelithiasis and cholecystectomy: our experience with two cases and literature review

查看全文 作　　者：Narasimhaiah [1]Srinivasaiah;Maneesh [2]Bhojak;Ralph [2]Jackson;Sean [1]Woodcock 高影响力作者 机构地区：[1]Department of Surgery, North Tyneside General Hospital Tyne and Wear, UK;[2]Department of Radiology, Freeman Hospital Tyne and Wear, UK高影响力机构 出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2008年第7卷第2期,共4页高影响力期刊 摘　　要：BACKGROUND:Complications from gallstones and laparoscopic cholecystectomy can be serious and fatal if there is a delay in recognition and treatment. We aim to present two unusual, life threatening vascular complications as a result of gallstones and laparoscopic cholecystectomy. Their management is highlighted with a brief review of literature. METHODS:Data for the article were gathered from clinical case note review. Radiology database was used for images. A brief literature review was undertaken using Pubmed search. The keyword used included hemobilia, pseudoaneurysm, arterio-biliary fistula and laparoscopic cholecystectomy. RESULTS:The article highlights two individual case reports. The first case constitutes an 81-year woman who had cystic arterial erosion causing hematemesis, while the second patient was a 57-year man who presented with hemobilia from a pseudoaneurysm of right hepatic artery (RHA) following laparoscopic cholecystectomy. Cystic arterial erosion was treated with subtotal cholecystectomy with duodenal defect closure while the pseudoaneurysm underwent radiological intervention. CONCLUSIONS:Cystic artery erosion and pseudoaneurysm causing arteriobiliary fistula are rare vascular complications related to the biliary tree. A high index of suspicion and timely intervention is important. Trauma to arteries should be avoided during laparoscopic cholecystectomy. 关 键 词：laparoscopic CHOLECYSTECTOMY HEMOBILIA HEMATEMESIS PSEUDOANEURYSM
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