title: Hemobilia following laparoscopic cholecystectomy: computed tomography findings and clinical outcome of transcatheter arterial embolization.
abstract: BACKGROUND
  Hemobilia following laparoscopic cholecystectomy (LC) can occur in the early or late postoperative course and poses a diagnostic and therapeutic challenge.
  
  
  OBJECTIVE
  To assess computed tomography (CT) findings and clinical outcomes after transcatheter arterial embolization (TAE) in patients presenting with hemobilia following LC.
  
  
  METHODS
  Fourteen patients treated for hemobilia following LC were included in the study. Three patients were diagnosed by endoscopy and 11 by abdominal contrast-enhanced CT. Coils or microcoils were superselectively deployed to occlude the bleeding vessel during TAE. Abdominal CT findings of hemobilia, and the success rate and complication of TAE were observed.
  
  
  RESULTS
  Abdominal CT provided the following signs of hemobilia: hematoma within the abdominal cavity and gallbladder fossa, blood clots containing high attenuation within the bile duct, biliary dilatation, pseudoaneurysm of the right hepatic artery, contrast extravasation, enhancement of the bile duct wall, and hypoperfusion of the right lobe. The success rate of TAE was 100% and rebleeding did not occur in any patient. Post-embolization syndrome and hepatic ischemia occurred in nine patients, which was associated with age and the time interval between the LC and TAE.
  
  
  CONCLUSIONS
  Abdominal CT provided direct signs that can aid in the diagnosis of hemobilia after LC. TAE allowed for successful treatment of hemobilia with minor complications.
authors.affiliation: Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Wen
authors.initials: W
authors.lastname: Feng
authors.affiliation: Department of Radiology, China Medical University Cancer Hospital, LiaoNing Cancer Hospital, Shenyang, Liaoning, PR China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yue
authors.affiliation: Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Lu
authors.initials: L
authors.lastname: ZaiMing
authors.affiliation: Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Liu
authors.initials: L
authors.lastname: ZhaoYu
authors.affiliation: Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, PR China qiyong_guo@163.com.
authors.forename: Guo
authors.initials: G
authors.lastname: Qiyong
mesh_terms: D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Laparoscopic cholecystectomy; complication; computed tomography (CT); hemobilia; transcatheter arterial embolization (TAE)