Postlaparoscopic Iatrogenic Pseudoaneurysms of the Arteries of the Peritoneal and Retroperitoneal Space

Parthenis, Dimitrios G.; Skevis, Kostas; Stathopoulos, Vasilis; Bellenis, Ion; Vassilakopoulos, Theodoros P.

doi:10.1097/sle.0b013e31819ca96b

Cited by 8 publications

(11 citation statements)

References 44 publications

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“…We found 97 eligible studies and a sum of 134 patients who presented with at least one symptomatic PA following LC during a 26-year period (1994–2020). [ 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 …”

Section: Resultsmentioning

confidence: 99%

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Symptomatic pseudoaneurysms following laparoscopic cholecystectomy

Lampropoulos

Markopoulos²,

Tsochatzis

et al. 2021

Journal of Minimal Access Surgery

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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.

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Section: Resultsmentioning

confidence: 99%

“…Two previous reviews of the literature have been published in the past which provided valuable information on this subject. [ 6 7 ]…”

Section: Introductionmentioning

confidence: 99%

Symptomatic pseudoaneurysms following laparoscopic cholecystectomy

Lampropoulos

Markopoulos²,

Tsochatzis

et al. 2021

Journal of Minimal Access Surgery

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“…In 73 patients out of 193, the vascular injury occurred in the cystic artery, which was the most affected vessel [ 6 ]. Parthenis et al in a review of literature mentioned the rarity of vascular pseudoaneurysms after laparoscopic surgeries and identified 66 relative cases where only three referred to cystic artery pseudoaneurysm and most of them concerned the right hepatic artery [ 7 ]. Another more recent review by Lampropoulos et al confirmed that the right hepatic artery was the most common site of pseudoaneurysm development, followed by the cystic artery [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another more recent review by Lampropoulos et al confirmed that the right hepatic artery was the most common site of pseudoaneurysm development, followed by the cystic artery [ 8 ]. Among laparoscopic procedures, laparoscopic cholecystectomy is associated more often with the formation of pseudoaneurysm followed by laparoscopic nephrectomies [ 7 ]. Clinical presentation of CAP may be in the early or late postoperative period, although in most cases, may occur in the first postoperative month [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Early Rupture of Iatrogenic Cystic Artery Pseudoaneurysm After Unsuccessful Laparoscopic Cholecystectomy: A Case Report

Christodoulou¹,

Liapis²

2022

Cureus

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Laparoscopic cholecystectomy has been established as the gold-standard method to deal with symptomatic cholelithiasis and cholecystitis. Although, like any other surgical procedure, it may have complications that affect the mortality and morbidity of patients. More specifically, the cystic artery pseudoaneurysm is considered a rare complication of laparoscopic cholecystectomy, which despite its rarity, may be fatal for the patient. Herein, we present the case of a 67-year-old man with a ruptured iatrogenic cystic artery pseudoaneurysm in the early postoperative period after laparoscopic cholecystectomy that converted to open wherein a cholecystostomy catheter was placed. The patient was hospitalized in our surgical unit, and he was treated with cystic artery embolization initially and secondary with elective open cholecystectomy.

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“…In laparoscopic surgeries, iatrogenic pseudoaneurysms have been reported as the causes of late postoperative bleeding, with a mean time of 6 weeks between the surgery and discovery of the pseudoaneurysm. 2 Similarly, in patients undergoing prostatectomies and cystectomies, pseudoaneurysms were the reported causes of delayed postoperative bleeding. 3 Among patients with cervical cancer, a case of life-threatening massive bleeding caused by a ruptured pseudoaneurysm was reported.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Postoperative Hemorrhagic Shock 7 Days After Robot-Assisted Radical Prostatectomy

Fujisaki

Takayama

Yamazaki

et al. 2020

Journal of Endourology Case Reports

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Background: Delayed postoperative bleeding after robot-assisted radical prostatectomy (RARP) is a rare lifethreatening condition. We present such a case wherein a patient developed hemorrhagic shock from a ruptured pseudoaneurysm arising from the epigastric artery and discuss its management. Case Presentation: A 71-year-old man with prostate cancer underwent RARP. The urethral catheter was removed on postoperative day 7; 80 minutes later, the patient suddenly lost consciousness and went into shock. Enhanced CT revealed intra-abdominal bleeding; however, the cause was unknown. Intraoperatively, bleeding was observed from the anterior abdominal wall, which likely corresponded to the epigastric artery. However, this was controlled with monopolar electrocautery. Because of unstable hemodynamics, hemostasis was immediately performed by laparotomy, and bleeding was noted from the previously coagulated right inferior epigastric artery. Therefore, the cause was considered to be the rupture of a pseudoaneurysm. Conclusion: Our experience suggests that monopolar electrocautery may be inadequate for controlling bleeding that may be encountered during RARP, possibly leading to pseudoaneurysm formation, which may cause a delayed life-threatening hemorrhage. Meticulous and precise hemostasis is key to avoiding this complication.

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Postlaparoscopic Iatrogenic Pseudoaneurysms of the Arteries of the Peritoneal and Retroperitoneal Space

Cited by 8 publications

References 44 publications

Symptomatic pseudoaneurysms following laparoscopic cholecystectomy

Symptomatic pseudoaneurysms following laparoscopic cholecystectomy

Early Rupture of Iatrogenic Cystic Artery Pseudoaneurysm After Unsuccessful Laparoscopic Cholecystectomy: A Case Report

Postoperative Hemorrhagic Shock 7 Days After Robot-Assisted Radical Prostatectomy

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