Hepatic artery injury in a six-year-old patient after laparoscopic cholecystectomy: A management challenge

Zeliha Akış Yıldız, Şeyma Meliha Su, Z. İlçe
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Abstract

Laparoscopic cholecystectomy is among the most common surgeries in adults and is increasing in the pediatric age group. However, data are lacking on complications of the surgery and their treatment in children. Although many case series can be found that address hepatic artery injury after cholecystectomy in adults, we could not find similar publications in the English literature relating to the pediatric age group. This report shares the complex diagnosis and treatment process of a six-year-old female patient who presented with jaundice eight months after laparoscopic cholecystectomy. During the treatment process, it was observed that the common bile duct went into lysis in the late period due to haptic artery injury. The treatment continued with redo hepaticojejunostomy and catheters passed through the anastomosis line in the patient, who had anastomotic stenosis after hepaticojejunostomy. Twenty-four months after the patient’s first operation, she had no active complaints. Complications may occur months after a cholecystectomy. In this case, arterial injury should be kept in mind. We wanted to contribute by presenting the first case in the literature on hepatic artery injury in the pediatric age group.
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一名六岁患者在腹腔镜胆囊切除术后出现肝动脉损伤:处理难题
腹腔镜胆囊切除术是成人最常见的手术之一,在儿童年龄组中也越来越常见。然而,有关儿童手术并发症及其治疗的数据却很缺乏。虽然有很多病例系列都涉及到成人胆囊切除术后肝动脉损伤的问题,但我们在英文文献中却找不到与儿童年龄组相关的类似出版物。本报告分享了一名六岁女性患者在腹腔镜胆囊切除术后八个月出现黄疸的复杂诊断和治疗过程。在治疗过程中,观察到胆总管在晚期因触动脉损伤而溶解。由于患者在肝空肠吻合术后出现吻合口狭窄,因此继续进行了重做肝空肠吻合术,并在吻合口线上穿刺导管。患者在第一次手术后 24 个月,没有任何不适症状。胆囊切除术后数月可能会出现并发症。在这种情况下,应注意动脉损伤。我们希望通过介绍文献中第一例儿科肝动脉损伤病例来对此做出贡献。
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