title: Hemobilia After Laparoscopic Cholecystectomy: Imaging Features and Management of an Unusual Complication.
abstract: OBJECTIVE
  To assess the imaging features and the management of hemobilia after laparoscopic cholecystectomy (LC).
  
  
  METHODS
  A total of 12 patients who were treated for hemobilia after LC were included in the study. Selective arteriography was performed to find the bleeding artery. Coils or microcoils were deployed superselectively to occlude the bleeding branch. The clinical course, imaging findings, the embolic effect, complications, and follow-up were evaluated.
  
  
  RESULTS
  Risk factors for hemobilia included a variant ductal anatomy, a variant cystic artery, and intraoperative adhesion. Abdominal computed tomography (CT) could provide the diagnostic signs as follows: a hematocele in the abdominal cavity, the gallbladder fossa, and the bile duct, biliary dilation, pseudoaneurysm of the right hepatic artery, and contrast extravasations on contrast-enhanced CT. No rebleeding occurred after the transcatheter arterial embolization in all patients without immediate procedural complications.
  
  
  CONCLUSIONS
  Gallbladder triangle anatomic variation and intraoperative adhesion were the risk factors for hemobilia after LC. Abdominal CT is a useful examination for the diagnosis. Transcatheter arterial embolization is the therapeutic option of choice.
authors.affiliation: *Department of Radiology, Shengjing Hospital, China Medical University, Shenyang †Department of Radiology, LiaoNing Cancer Hospital, DaLian Medical University Clinical Oncology College, Shenyang, Liaoning, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wen
authors.forename: Yue
authors.initials: Y
authors.lastname: Dong
authors.forename: Zai Ming
authors.initials: ZM
authors.lastname: Lu
authors.forename: Zhao Yu
authors.initials: ZY
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Qi Yong
authors.initials: QY
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome