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Vascular emergencies in cholelithiasis and cholecystectomy: our experience with two cases and literature review |
Narasimhaiah Srinivasaiah, Maneesh Bhojak, Ralph Jackson and Sean Woodcock |
Tyne and Wear, UK
Author Affiliations: Department of Surgery, North Tyneside General Hospital (Srinivasaiah N and Woodcock S), and Department of Radiology, Freeman Hospital (Bhojak M and Jackson R), Tyne and Wear, UK
Corresponding Author: Narasimhaiah Srinivasaiah, Academic Surgical Unit, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, UK (Tel: 0044-7769775552; Email: simha_anu@yahoo.com) |
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Abstract 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 keywords 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.
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Cite this article: |
Srinivasaiah N,
Bhojak M,
Jackson R,
et al.
Vascular emergencies in cholelithiasis and cholecystectomy: our experience with two cases and literature review.
Hepatobiliary Pancreat Dis Int
2008;
7(2):
217-280. DOI:
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URL: |
http://dx.doi.org/ OR http://www.hbpdint.com/EN/Y2008/V7/I2/217 |
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