Hepatic Artery Angiography and Embolization for Hemobilia Following Laparoscopic Cholecystectomy

Journal Article · Fri Jan 15 04:00:00 EST 1999 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900323· OSTI ID:21080341

Nicholson, Tony; Travis, Simon; Ettles, Duncan; Dyet, John ^[1]; Sedman, Peter; Wedgewood, Kevin; Royston, Christopher ^[2]

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1. Department of Vascular Radiology, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ (United Kingdom)
2. Department of Surgery, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ (United Kingdom)

Purpose: The effectiveness of angiography and embolization in diagnosis and treatment were assessed in a cohort of patients presenting with upper gastrointestinal hemorrhage secondary to hepatic artery pseudoaneurysm following laparoscopic cholecystectomy. Methods: Over a 6-year period 1513 laparoscopic cholecystectomies were carried out in our region. Nine of these patients (0.6%) developed significant upper gastrointestinal bleeding, 5-43 days after surgery. All underwent emergency celiac and selective right hepatic artery angiography. All were treated by coil embolization of the right hepatic artery proximal and distal to the bleeding point. Results: Pseudoaneurysms of the hepatic artery adjacent to cholecystectomy clips were demonstrated in all nine patients at selective right hepatic angiography. In three patients celiac axis angiography alone failed to demonstrate the pseudoaneurysm. Embolization controlled hemorrhage in all patients with no further bleeding and no further intervention. One patient developed a candidal liver abscess in the post-procedure period. All patients are alive and well at follow-up. Conclusion: Selective right hepatic angiography is vital in the diagnosis of upper gastrointestinal hemorrhage following laparoscopic cholecystectomy. Embolization offers the advantage of minimally invasive treatment in unstable patients, does not disrupt recent biliary reconstruction, allows distal as well as proximal control of the hepatic artery, and is an effective treatment for this potentially life-threatening complication.

• OSTI ID: 21080341
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 22; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABSCESSES
ARTERIES
BIOMEDICAL RADIOGRAPHY
DIAGNOSIS
HEMORRHAGE
LIVER
PATIENTS
SURGERY