| REVIEW ARTICLE
|Year : 2021 | Volume
| Issue : 4 | Page : 450-457
Symptomatic pseudoaneurysms following laparoscopic cholecystectomy: Focus on an unusual and dangerous complication
Charalampos Lampropoulos1, George Markopoulos2, Stylianos Tsochatzis3, Aggeliki Bellou4, Theofilos Amanatidis3, Dimitrios Kehagias5, George Papadopoulos6, Ioannis Kehagias5
1 Department of Surgery, General Hospital of Ilia ‘Andreas Papandreou’, Pyrgos, Greece
2 Department of Surgery, Florina General Hospital, Florina, Greece
3 Department of Surgery, General Hospital of Patras ‘St. Andrew’, Patras, Greece
4 Department of Pulmonary Medicine, General University Hospital of Patras, Patras, Greece
5 Department of Surgery, General University Hospital of Patras, Patras, Greece
6 General Surgery Clinic, IASO General Hospital, Athens, Greece
Background: Laparoscopic cholecystectomy (LC) has been associated with an increase in the incidence of biliary and vascular injuries. Pseudoaneurysms (PAs) following LC are rare life-threatening events with limited available experience regarding diagnosis and treatment.
Materials and Methods: An extensive review of literature during a 26-year period (1994–2020) using MEDLINE® database and Google Scholar® academic search engine revealed 134 patients with at least one symptomatic PA following LC.
Results: Nearly 81% of patients with PAs become symptomatic during the first 8 weeks following LC. The most common symptoms were gastrointestinal bleeding (74%) and abdominal pain (61%). In 28% of cases, there was a concomitant bile duct injury or leak from the cystic duct stump, whereas in about one-third of cases, PAs presented following an uneventful LC. The most common involved arteries were the right hepatic artery (70%), the cystic artery (19%) or both of them (3%). Trans-arterial embolisation was the favoured first-line treatment with a success rate of 83%. During a median follow-up of 9 months, the mortality rate was 7%.
Conclusion: Clinicians should be aware of the PA occurrence following LC. Prompt diagnosis and treatment are essential.
Dr. Charalampos Lampropoulos
Naxou 4, Rio - Patras, Zip Code: 26504
Source of Support: None, Conflict of Interest: None
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