A Case of Embolization of a Ruptured Pseudoaneurysm of the Proper Hepatic Artery After Extended Right Hepatectomy and Extrahepatic Bile Duct Resection for Hilar Cholangiocarcinoma

Abstract

We describe a case of transcatheter arterial embolization（TAE）of a proper hepatic artery. A 72-year-old woman underwent extended right hepatectomy with extrahepatic bile duct resection for hilar cholangiocarcinoma after percutaneous transhepatic portal vein embolization of the right branch of the portal vein. Anastomotic leakage of the cholangiojejunostomy occurred postoperatively. On postoperative day 44, we observed massive bleeding from rupture of a pseudoaneurysm at the right hepatic artery dissection. We performed urgent angiography and embolized the proper hepatic artery. Although drainage of a liver abscess was needed, liver failure did not occur. We concluded that TAE of the proper hepatic artery after hepatectomy was not the cause of the liver failure in this case, because we performed TAE 6 weeks after the hepatectomy and the hepatic blood flow developed through an extrahepatic artery. In regard to the ruptured pseudoaneurysm after the hepatectomy with hepatic mobilization, the postoperative duration was considered to be important for determining the need for revascularization.