title: Successful utilization of coronary covered stents to treat a common hepatic artery pseudoaneurysm secondary to pancreatic fistula after Whipple's procedure: report of a case.
abstract: A 73-year-old man underwent a pylorus-preserving Whipple's procedure for distal cholangiocarcinoma. His postoperative course was complicated by the formation of a pancreatic fistula, which was initially managed conservatively. On postoperative day (POD) 86, he lost 100 ml of blood from the site of the pancreatic fistula. Contrast-enhanced computed tomography (CT) showed a pseudoaneurysm, 12 mm in diameter, in the common hepatic artery. The diameter of the pseudoaneurysm increased to 15 mm on POD 89, so we implanted coronary covered stents to prevent massive bleeding from rupture and to retain hepatic arterial flow. Six days after implantation, computed tomography findings confirmed a thrombosed pseudoaneurysm as well as patent hepatic arterial flow. Follow-up CT 18 months after surgery showed patent hepatic arterial flow. There have been no signs of rebleeding or abnormal liver function.
authors.affiliation: Department of Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Sasaki
authors.forename: Kazumitsu
authors.initials: K
authors.lastname: Ueda
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Kana
authors.initials: K
authors.lastname: Yoshida
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sako
authors.forename: Munekatsu
authors.initials: M
authors.lastname: Sato
authors.forename: Minoru
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D018281:Cholangiocarcinoma / Q000150:complications / Q000601:surgery; D003287:Contrast Media; D004621:Embolization, Therapeutic; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D010185:Pancreatic Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media