JILTI. 2025; 3(2): 61-63 | DOI: 10.14744/jilti.2025.05706

Management of Late Hemorrhage from Hepatic Artery Pseudoaneurysm after Gallbladder Cancer Surgery: A Case Report

Oguzhan Sal¹, Emre Adalier², Gorkem Uzunyolcu¹, Celal Caner Ercan³, Mehmet Semih Cakir³, Neslihan Berker⁴, Melek Buyuk⁴, Beslen Goksoy¹, Kursat Rahmi Serin^1
1Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
²University of Pavia, Medicine & Surgery, Pavia, Italy
³Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
⁴Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye

Gallbladder cancer carries a poor prognosis, with surgical resection being the only curative option. However, complex anatomy can lead to serious postoperative complications.
We present a case of a 58-year-old male who developed a hepatic artery pseudoaneurysm following radical laparoscopic cholecystectomy for gallbladder cancer. The procedure was complicated by an aberrant bile duct injury, requiring hepaticoduodenostomy. He had a high-flow biliary fistula postoperatively. On postoperative day 7, he presented with hemorrhage and hemodynamic instability. CT angiography revealed a pseudoaneurysm of hepatic artery, and emergency surgical exploration was performed after failed coil embolization. The pseudoaneurysm was repaired, and segment 6 resection was performed for anastomotic dehiscence and necrosis. The patient recovered, received adjuvant chemotherapy, and experienced no further complications.
This case emphasizes the need for multidisciplinary management in complex biliary surgery and highlights the potential for rare but serious complications like pseudoaneurysms.

Keywords: Biliary Fistula, Hepaticojejunostomy, Hepatectomy, Bleeding, Cholecystectomy

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