A Case of a Ruptured Right Hepatic Artery Successfully Treated with Arterio-Portal Shunting After an Extended Left Lobectomy

Abstract

We report herein on a case of a ruptured right hepatic artery successfully treated with an arterio-portal shunt after an extended left lobectomy. A 65-year-old woman underwent an extended left lobectomy combining resection and reconstruction of the right hepatic artery for an intrahepatic cholangiocarcinoma. The right hepatic artery was ruptured on the fourth day after surgery. She fell into severe hemorrhagic shock and underwent an arterio-portal shunt with the right hepatic artery and right portal vein. She was discharged on the 61st day after surgery though acute respiratory distress syndrome, bile fistula, and intra-abdominal abscess had developed. Hemorrhage from the hepatic artery is a life-threatening complication. Arterio-portal shunting could be a way to avoid hepatonecrosis and treatment of a ruptured right hepatic artery and severe hemorrhagic shock.