Delayed Right Hepatic Artery Haemorrhage After Iatrogenic Gallbladder by Laparoscopic Cholecystectomy that Required a Liver Transplant Due to Acute Liver Failure: Clinical Case and Review of the Literature

• Published in: Cirugia española (English ed.) Vol. 89; no. 10; pp. 670 - 676
• Main Authors: Robles Campos, R, Marín Hernández, C, Fernández Hernández, J.A, Sanchez Bueno, F, Ramirez Romero, P, Pastor Perez, P, Parrilla Paricio, P
• Format: Journal Article
• Language: English
• Published: Elsevier España 01-12-2011
• Subjects: Colecistectomía laparoscópica; Fallo hepático fulminante; Fulminant; Laparoscopic cholecystectomy; Lesión arteria hepática derecha; Liver transplant; Right hepatic artery injury; Surgery; Trasplante hepático; Lesión arteria hepática derecha; Colecistectomía laparoscópica; Laparoscopic cholecystectomy; Right hepatic artery injury; Liver transplant; Fallo hepático fulminante; Trasplante hepático; Fulminant
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2011.07.001

Abstract Introduction Right hepatic artery (RHA) injury after laparoscopic cholecystectomy (LC) may go unnoticed clinically, but can sometimes cause necrosis of the right lobe. Exceptionally, when the necrosis spreads to segment IV, fulminant liver failure (FLF) may occur, and an urgent liver transplantation (LT) may be required. Patients and method We provide a review of the literature on patients with indication for an LT due to vascular damage caused by bile duct injury following LC. The case reported herein is the fourth described in the specialized literature of LT due to RHA injury after LC and the second of FLF after RHA injury. Results LT due to RHA injury was performed in 3 of 13 patients reported in the literature: one LT was performed at 3 months due to FLF, after an extended right hepatectomy was performed, and the remaining two were performed due to secondary biliary cirrhosis. Our patient was transplanted due to FLF 15 days after the injury. Conclusions RHA injury after LC may require LT due to FLF. Although exceptional, this possibility should be considered when there are RHA complications that may require occlusion.