title: Laparoscopic management of post-cholecystectomy sectoral artery pseudoaneurysm.
abstract: Vascular injuries during laparoscopic cholecystectomy can occur similar to biliary injuries and mostly represented by intraoperative bleeding. Hepatic artery system pseudoaneurysm are rare. It occurs in the early or late postoperative course. Patients present with pallor, signs of haemobillia and altered liver function. We report a case of right posterior sectoral artery pseudoaneurysm detected 2 weeks after laparoscopic cholecystectomy and successfully repaired laparoscopically. We also describe how laparoscopic pringle clamping saved the conversion. The actively bleeding right posterior sectoral artery pseudoaneurysm was diagnosed by CT angiogram. Embolisation, usually the treatment of choice, would have risked liver insufficiency as hepatic artery proper was at risk because the origin the bleeding artery was just after its bifurcation. Isolated right hepatic artery embolisation can also cause hepatic insufficiency. To our knowledge this is the first reported case of laparoscopic repair of post-laparoscopic cholecystectomy bleeding sectoral artery pseudoaneurysm.
authors: Department of Surgery, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors: Nilanjan
authors: N
authors: Panda
authors: Department of Surgery, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors: Mohan
authors: M
authors: Narasimhan
authors: Department of Surgery, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors: Alwin
authors: A
authors: Gunaraj
authors: Department of Surgery, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.
authors: Ramesh
authors: R
authors: Ardhanari
keywords: Laparoscopic repair of aneurysm; post cholecystectomy vascular injury; pseudoaneurysm; right posterior sectoral artery