scholarly journals Hemobilia due to Hepatic artery pseudoaneurysm secondary to collateral circulation formation after liver trauma: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiqi Wu ◽  
Qianling Sun ◽  
Bin Mei
Keyword(s):  
Hepatic Artery ◽  
Collateral Circulation ◽  
Arterial Embolization ◽  
Liver Trauma ◽  
Hepatic Artery Ligation ◽  
Artery Ligation ◽  
Artery Pseudoaneurysm ◽  
Recurrent Hemorrhage ◽  
Hepatic Artery Pseudoaneurysm

Abstract Background Hemobilia due to rupture of hepatic artery pseudoaneurysm and recurrent hemorrhage caused by hepatic artery collateral circulation are both rare complications after liver trauma. There have been a number of separate reports of both complications, but no cases have been reported in which the two events occurred in the same patient. Here we report a recurrent hemorrhage in the bile duct due to hepatic artery pseudoaneurysm secondary to collateral circulation formation after hepatic artery ligation in a patient with liver trauma. Case presentation A 52-year-old male patient was admitted to our hospital for liver trauma (Grade IV according to the American Association for the Surgery of Trauma (AAST) grading system) with active bleeding after a traffic accident. Hepatic artery ligation was performed for hemostasis. Three months after the surgery, the patient was readmitted for melena and subsequent hematemesis. Selective angiography examination revealed the formation of collateral circulation between the superior mesenteric artery and right hepatic artery. Moreover, a ruptured hepatic artery pseudoaneurysm was observed and transcatheter arterial embolization (TAE) was performed for hemostasis at the same time. After the treatment, the patient recovered very well and had an uneventful prognosis until the last follow-up. Conclusion For patients with hepatic trauma, the selection of the site of hepatic artery ligation and the diagnosis and treatment methods of postoperative biliary hemorrhage are crucial for the prognosis of the disease.

scholarly journals Two-stage laparoscopic resection of giant hepatoblastoma in infants combined with liver partial partition and artery ligation

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yaohao Wu ◽  
Lexiang Zeng ◽  
Ronglin Qiu ◽  
Jie Zhang ◽  
Jianhang Su ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Hepatic Artery ◽  
Laparoscopic Resection ◽  
Laparoscopic Hepatectomy ◽  
Hepatic Artery Ligation ◽  
Two Stage ◽  
Artery Ligation ◽  
Partial Partition ◽  
Stage 1

Abstract Purpose Laparoscopic resection of giant hepatoblastoma (HB) in children has long been a subject of controversy. Here, a new procedure of two-stage laparoscopic resection of giant HB in infants was firstly reported and the feasibility was discussed. Methods The clinical data of three infants with HB were retrospectively reviewed, all of which received 3–5 cycles of neoadjuvant chemotherapy. Stage 1 laparoscopic selective hepatic artery ligation and liver partial partition were performed. Stage 2 laparoscopic hepatectomy was performed 2 weeks later. Results The results demonstrated that (1) the tumors shrank considerably in size and had relatively clear boundaries after neoadjuvant chemotherapy; (2) after stage 1 surgery, the tumor volume further reduced, while the intratumoral necrosis expanded; (3) 2 weeks later, stage 2 laparoscopic hepatectomy was performed successfully; (4) none of the cases had intraoperative complications such as tumor rupture, air embolism, hemorrhage, biliary fistula, or liver failure, and there was no recurrence or metastasis during follow-up. Conclusions Two-stage laparoscopic hepatectomy associating selective hepatic artery ligation and liver partial partition for HB in infants has the benefits of small invasiveness, fast recovery, improved safety, and high feasibility. However, more cases and longer follow-up are needed to assess its long-term efficacy.

scholarly journals Two-stage laparoscopic resection of giant hepatoblastoma in infants combined with liver partial partition and artery ligation

2020 ◽  
Author(s):  
Yaohao Wu ◽  
Lexiang Zeng ◽  
Ronglin Qiu ◽  
Jie Zhang ◽  
Jianhang Su ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Hepatic Artery ◽  
Laparoscopic Resection ◽  
Intraoperative Complications ◽  
Laparoscopic Hepatectomy ◽  
Hepatic Artery Ligation ◽  
Two Stage ◽  
Artery Ligation ◽  
Partial Partition

Abstract Purpose Laparoscopic resection of giant hepatoblastoma (HB) in children has long been a subject of controversy. Here a new procedure of two-stage laparoscopic resection of giant HB in infants was firstly reported and the feasibility was discussed. Methods The clinical data of 3 infants with HB were retrospectively reviewed, all of which received 3–5 cycles of neoadjuvant chemotherapy. Stage one laparoscopic selective hepatic artery ligation and liver partial partition were performed. Stage two laparoscopic hepatectomy was performed two weeks later. Results The results demonstrated that: 1) The tumors shrank considerably in size and had relatively clear boundaries after neoadjuvant chemotherapy; 2) After stage one surgery, the tumor volume further reduced, while the intratumoral necrosis expanded. 3) Two weeks later, stage two laparoscopic hepatectomy was performed successfully; 4) None of the cases had intraoperative complications such as tumor rupture, air embolism, hemorrhage, biliary fistula or liver failure, and there was no recurrence or metastasis during follow-up. Conclusions Two-stage laparoscopic hepatectomy associating selective hepatic artery ligation and liver partial partition for HB in infants has the benefits of small invasiveness, fast recovery, improved safety and high feasibility. However, more cases and longer follow-up are needed to assess its long-term efficacy.

scholarly journals HEPATIC ARTERY LIGATION FOR PORTAL HYPERTENSION

1953 ◽  
Vol 137 (4) ◽  
pp. 507-515 ◽  
Author(s):  
Gerard Desforges ◽  
Alexander J. A. Campbell ◽  
Stanley L. Robbins
Keyword(s):  
Portal Hypertension ◽  
Hepatic Artery ◽  
Hepatic Artery Ligation ◽  
Artery Ligation

scholarly journals Arterio-biliary fistula caused by a hepatic artery pseudoaneurysm in a recently performed liver transplant: successful resolution and long-term liver implant preservation using a covered coronary stent

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Alfredo Páez-Carpio ◽  
Elena Serrano ◽  
Federico Zarco ◽  
Constantino Fondevila ◽  
Marta Burrel
Keyword(s):  
Bile Duct ◽  
Liver Transplant ◽  
Hepatic Artery ◽  
Biliary Fistula ◽  
Coronary Stent ◽  
Artery Pseudoaneurysm ◽  
Hepatic Artery Pseudoaneurysm ◽  
Successful Resolution ◽  
Standardized Treatment

Abstract Background The formation of a hepatic artery pseudoaneurysm in a liver implant is a rare but potentially fatal complication. Fistulization of such pseudoaneurysms into the bile duct is sporadic. The most common causes of hepatic artery pseudoaneurysm are infection at the anastomosis site, inadequate surgical technique, and an iatrogenic origin due to minimally invasive procedures. Currently, there is no standardized treatment in neither of these complications, with surgery and various endovascular procedures among the alternatives available. None of these therapeutic approaches has demonstrated a significant increase in long-term liver implant preservation. Case presentation A 56-year-old man with a two-month liver transplant presented with massive upper gastrointestinal bleeding and hemobilia shortly after the performance of an endoscopic retrograde cholangiopancreatography due to the presence of a hepatic artery pseudoaneurysm with fistulization into the bile duct. This case report describes the successful treatment of both complications, the hepatic artery pseudoaneurysm and the arterio-biliary fistula, using a covered coronary stent placed in the hepatic artery. A year and a half after treatment, the patient maintains a preserved liver implant and a patent hepatic artery. Conclusions Treatment of a hepatic artery pseudoaneurysm with fistulization into bile duct using a covered coronary stent allowed the correct repair of the defect, adequate hemorrhage control, and long-term liver implant preservation.

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