BACKGROUND Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians;this,its etiology and presentation as well as appropriate treatments are not well studied.Although it is treated by removal of th...BACKGROUND Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians;this,its etiology and presentation as well as appropriate treatments are not well studied.Although it is treated by removal of the diseased gallbladder and cystic artery,such surgery can be difficult and risky if acute inflammation with bleeding occurs,and not every patient can tolerate the surgery.CASE SUMMARY An 81-year-old man complained of epigastric pain and tarry stool passage that lasted for 3 d.He had a medical history of poor cardiopulmonary function.The computed tomographic scan of abdomen showed cystic artery pseudoaneurysm and dilatation of gallbladder.Because of high adverse outcomes related to general anesthesia,the patient was successfully managed with endovascular embolization for this cystic artery pseudoaneurysm and percutaneous drainage for the distended gallbladder.CONCLUSION A patient with cystic artery pseudoaneurysm may quickly deteriorate with the occurrence of concurrent arterial bleeding and sepsis.This report presents the case of a patient who did not undergo surgery due to multiple cardiopulmonary comorbidities and whose condition was managed successfully with embolization and biliary drainage.Endovascular embolization and biliary drainage may provide an alternative option to manage this complicated condition.展开更多
AIM： To investigate the anatomic variations in the cystic artery by laparoscopy, and to provide a new classification system for the guidance of laparoscopic surgeons.METHODS： Six hundred patients treated with laparo...AIM： To investigate the anatomic variations in the cystic artery by laparoscopy, and to provide a new classification system for the guidance of laparoscopic surgeons.METHODS： Six hundred patients treated with laparoscopic cholecystectomy from June 2005 to May 2006 were studied retrospectively, The laparoscope of 30° （Stryker, American） was applied, Anatomic structures of cystic artery and conditions of Calot＇s triangle under laparoscope were recorded respectively,RESULTS： Laparoscopy has revealed there are many anatomic variations of the cystic artery that occur frequently. Based on our experience with 600 laparoscopic cholecystectomies, we present a new classification of anatomic variations of the cystic artery, which can be divided into three groups： （1） Calot＇s triangle type, found in 513 patients （85.5%）; （2） outside Calot＇s triangle, found in 78 patients （13%）; （3） compound type, observed in 9 patients （1.5%）.CONCLUSION： Our classification of the anatomic variations of the cystic artery uncontrollable cystic artery extrahepatic bile duct injury. will be useful for decreasing hemorrhage, and avoiding extrahepatic bile duct injury.展开更多
A 76-year-old man with known situs inversus totalis presented with leE-sided discomfort. Abdominal ultrasonography and CT scan confirmed the diagnosis of a gallstone, as well as, situs inversus; the liver and gallblad...A 76-year-old man with known situs inversus totalis presented with leE-sided discomfort. Abdominal ultrasonography and CT scan confirmed the diagnosis of a gallstone, as well as, situs inversus; the liver and gallbladder on the left side and the spleen on the right. The biliary system was thought to be left-right reversal, mirror image in the view of drip infusion cholangiogram and MRI. Laparoscopic cholecy stectomy was safely performed, despite of unexpected aberrant cystic artery running inferior to cystic duct of situs inversus. Laparoscopic surgeon should be careful for view of reversed relationships and also existence of other anomalies.展开更多
BACKGROUND:Spontaneous hemoperitoneum of hepato- biliary origin is commonly due to hemorrhage from a liver tumor.It is rarely caused by spontaneous rupture of aneurysm in visceral arteries. METHODS:We report an unusua...BACKGROUND:Spontaneous hemoperitoneum of hepato- biliary origin is commonly due to hemorrhage from a liver tumor.It is rarely caused by spontaneous rupture of aneurysm in visceral arteries. METHODS:We report an unusual case of hemoperitoneum caused by rupture of cystic artery pseudoaneurysm,and also outline the approach to its management through surgical and radiological methods. RESULTS:In our patient,the pseudoanurysm was initially treated with percutaneous thrombin injection.However this method of treatment failed after initial success.The pseudoanurysm was finally obliterated successfully using microcoil embolization. CONCLUSIONS:The mainstay of treatment of cystic artery pseudoaneurysm is cholecystectomy and ligation of the aneurysm.Recent publications showed success in using microcoil embolisation.In this case we also outline the use of percutaneous thrombin injection as a definitive treatment method and discuss its success or failure as a new method of treatment.展开更多
BACKGROUND:Aneurysm of the cystic artery is no common,and it is a rare cause of hemobilia.Most o reported cases are pseudoaneurysms resulting from eithe an inflammatory process in the abdomen or abdomina trauma. METHO...BACKGROUND:Aneurysm of the cystic artery is no common,and it is a rare cause of hemobilia.Most o reported cases are pseudoaneurysms resulting from eithe an inflammatory process in the abdomen or abdomina trauma. METHOD:We report a healthy individual who developed hemobilia and acute pancreatitis associated with cysti artery aneurysm. RESULT:The patient was managed with angio-embolization with an uneventful post-embolization course. CONCLUSIONS:Visceral artery aneurysms are rare and can rupture with potentially grave outcome due to excessive bleeding.Angiographic embolization as a common method of treatment for visceral artery aneurysms was used in ou patient with good outcome.展开更多
Cholecystitis is a common disease in East Asia. Some of the patients developed cystic artery pseudoaneurysm,a rare complication of cholecystitis. Over the past decades, there have been Tess than 20 reports of patients...Cholecystitis is a common disease in East Asia. Some of the patients developed cystic artery pseudoaneurysm,a rare complication of cholecystitis. Over the past decades, there have been Tess than 20 reports of patients with cystic artery pseudoaneurysm in the literature. Among them, three of the patients had gallbladder perforation which led to hemorrhagic shock,la We report a case of an 88-year-old woman with a cystic artery pseudoaneurysm following an episode of acute cholecystitis.展开更多
文摘BACKGROUND Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians;this,its etiology and presentation as well as appropriate treatments are not well studied.Although it is treated by removal of the diseased gallbladder and cystic artery,such surgery can be difficult and risky if acute inflammation with bleeding occurs,and not every patient can tolerate the surgery.CASE SUMMARY An 81-year-old man complained of epigastric pain and tarry stool passage that lasted for 3 d.He had a medical history of poor cardiopulmonary function.The computed tomographic scan of abdomen showed cystic artery pseudoaneurysm and dilatation of gallbladder.Because of high adverse outcomes related to general anesthesia,the patient was successfully managed with endovascular embolization for this cystic artery pseudoaneurysm and percutaneous drainage for the distended gallbladder.CONCLUSION A patient with cystic artery pseudoaneurysm may quickly deteriorate with the occurrence of concurrent arterial bleeding and sepsis.This report presents the case of a patient who did not undergo surgery due to multiple cardiopulmonary comorbidities and whose condition was managed successfully with embolization and biliary drainage.Endovascular embolization and biliary drainage may provide an alternative option to manage this complicated condition.
文摘AIM： To investigate the anatomic variations in the cystic artery by laparoscopy, and to provide a new classification system for the guidance of laparoscopic surgeons.METHODS： Six hundred patients treated with laparoscopic cholecystectomy from June 2005 to May 2006 were studied retrospectively, The laparoscope of 30° （Stryker, American） was applied, Anatomic structures of cystic artery and conditions of Calot＇s triangle under laparoscope were recorded respectively,RESULTS： Laparoscopy has revealed there are many anatomic variations of the cystic artery that occur frequently. Based on our experience with 600 laparoscopic cholecystectomies, we present a new classification of anatomic variations of the cystic artery, which can be divided into three groups： （1） Calot＇s triangle type, found in 513 patients （85.5%）; （2） outside Calot＇s triangle, found in 78 patients （13%）; （3） compound type, observed in 9 patients （1.5%）.CONCLUSION： Our classification of the anatomic variations of the cystic artery uncontrollable cystic artery extrahepatic bile duct injury. will be useful for decreasing hemorrhage, and avoiding extrahepatic bile duct injury.
文摘A 76-year-old man with known situs inversus totalis presented with leE-sided discomfort. Abdominal ultrasonography and CT scan confirmed the diagnosis of a gallstone, as well as, situs inversus; the liver and gallbladder on the left side and the spleen on the right. The biliary system was thought to be left-right reversal, mirror image in the view of drip infusion cholangiogram and MRI. Laparoscopic cholecy stectomy was safely performed, despite of unexpected aberrant cystic artery running inferior to cystic duct of situs inversus. Laparoscopic surgeon should be careful for view of reversed relationships and also existence of other anomalies.
文摘BACKGROUND:Spontaneous hemoperitoneum of hepato- biliary origin is commonly due to hemorrhage from a liver tumor.It is rarely caused by spontaneous rupture of aneurysm in visceral arteries. METHODS:We report an unusual case of hemoperitoneum caused by rupture of cystic artery pseudoaneurysm,and also outline the approach to its management through surgical and radiological methods. RESULTS:In our patient,the pseudoanurysm was initially treated with percutaneous thrombin injection.However this method of treatment failed after initial success.The pseudoanurysm was finally obliterated successfully using microcoil embolization. CONCLUSIONS:The mainstay of treatment of cystic artery pseudoaneurysm is cholecystectomy and ligation of the aneurysm.Recent publications showed success in using microcoil embolisation.In this case we also outline the use of percutaneous thrombin injection as a definitive treatment method and discuss its success or failure as a new method of treatment.
文摘BACKGROUND:Aneurysm of the cystic artery is no common,and it is a rare cause of hemobilia.Most o reported cases are pseudoaneurysms resulting from eithe an inflammatory process in the abdomen or abdomina trauma. METHOD:We report a healthy individual who developed hemobilia and acute pancreatitis associated with cysti artery aneurysm. RESULT:The patient was managed with angio-embolization with an uneventful post-embolization course. CONCLUSIONS:Visceral artery aneurysms are rare and can rupture with potentially grave outcome due to excessive bleeding.Angiographic embolization as a common method of treatment for visceral artery aneurysms was used in ou patient with good outcome.
文摘Cholecystitis is a common disease in East Asia. Some of the patients developed cystic artery pseudoaneurysm,a rare complication of cholecystitis. Over the past decades, there have been Tess than 20 reports of patients with cystic artery pseudoaneurysm in the literature. Among them, three of the patients had gallbladder perforation which led to hemorrhagic shock,la We report a case of an 88-year-old woman with a cystic artery pseudoaneurysm following an episode of acute cholecystitis.
