Pseudoaneurysm of the right hepatic artery following cholangiocarcinoma resection. A case report and review of the literature.

Pseudoaneurysms of the hepatic artery are infrequent, but potentially fatal. Apart from the performance of percutaneous techniques, such lesions are fundamentally produced as a result of surgery. The causal surgical techniques may sometimes be quite complex, though in other cases they are very common (e.g. laparoscopic cholecystectomy). Knowledge of such aneurysms is therefore of great interest for general surgeons, with a view to prompt diagnosis and adequate management of potential digestive and/or peritoneal bleeding--this being the typical form of presentation of hepatic artery aneurysms. We present the case of a 70-year-old woman with a pseudoaneurysm of the right hepatic artery that manifested as massive upper digestive bleeding and abdominal pain 13 days after en bloc resection of the gallbladder and choledochus with regional lymphadenectomy due to cholangiocarcinoma. Management comprised emergency surgery with ligation of the right branch of the hepatic artery and reconstruction of the biliary anastomosis according to the Hasegawa technique.