術後右肝動脈仮性動脈瘤の破裂に対し救命し得た1例

A 63-year-old man who was diagnosed acute cholecystitis underwent PTGBD and subsequently open cholecystectomy. 13days after operation, the obvious bleeding was suddenly happened. Enhanced abdominal CT and selective ceriac angiography revealed a pseudoaneurysm at the right hepatic artery. Transcatheter embolization (TAE) of the aneurysm was performed. The bleeding ceased, but 1day after TAE the recurrent bleeding was happened. Operative ligation of the right hepatic artery successfully controlled the bleeding and the patint was discharged 112days after cholecystectomy without problems. In dissecting the gall bladder away from the liver bed, the use of electrocauterisation may injure the right hepatic artery and result in a pseudoaneurysm. Surgical procedure shoud be more careful. If the bleeeding was happened, the treatment shoud be firstly TAE and secondly surgical operation.