Feng Wen1, Yue Dong, Zai Ming Lu, Zhao Yu Liu, Wei Li, Qi Yong Guo. 1. *Department of Radiology, Shengjing Hospital, China Medical University, Shenyang †Department of Radiology, LiaoNing Cancer Hospital, DaLian Medical University Clinical Oncology College, Shenyang, Liaoning, China.
Abstract
PURPOSE: To assess the imaging features and the management of hemobilia after laparoscopic cholecystectomy (LC). MATERIALS AND 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.
PURPOSE: To assess the imaging features and the management of hemobilia after laparoscopic cholecystectomy (LC). MATERIALS AND 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: Norman O Machado; Adil Al-Zadjali; Anupam K Kakaria; Shahzad Younus; Mohamed A Rahim; Rashid Al-Sukaiti Journal: Sultan Qaboos Univ Med J Date: 2017-06-20
Authors: Lucia Romano; Gianni Lazzarin; Marco Varrassi; Alessandra Di Sibio; Vincenzo Vicentini; Mario Schietroma; Francesco Carlei; Antonio Giuliani Journal: Acta Biomed Date: 2021-04-30