Combined proper hepatic artery and common hepatic duct injury in open cholecystectomy: case report and review of the literature.
A 24-y-old male patient underwent elective open cholecystectomy at another center. On the third postoperative day, he developed fever and jaundice, for which he underwent reoperation at the same center on the seventh postoperative day. During the second surgery, massive bleeding was encountered, suture ligations were applied, and T-tube drainage was performed. After the surgery was completed, the patient developed hepatic microabscess, and sepsis ensued. The patient presented at this hospital for further evaluation. To rule out vascular injury, which was suspected in this patient, celiac angiography was performed; it showed that the hepatic artery was occluded near the eminence of the gastroduodenal artery, and the liver was supplied by many collaterals. After the patient's condition had stabilized and the sepsis had resolved, Roux-N-Y hepaticojejunostomy was performed on the 59th d after admission.
Salman
Bülent
B
Department of Surgery, Gazi University Faculty of Medicine, Anakara Turkey. bsalman@yahoo.com
Akyurek
Nusret
N
Onal
Baran
B
Cindoruk
Mehmet
M
D000328:Adult; D002763:Cholecystectomy / Q000009:adverse effects*; D006499:Hepatic Artery / Q000293:injuries*; D006500:Hepatic Duct, Common / Q000293:injuries*; D006801:Humans; D007565:Jaundice / Q000209:etiology / Q000601:surgery; D008100:Liver Abscess / Q000209:etiology / Q000601:surgery; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation