SUCCESSFUL VASCULAR RECONSTRUCTION AFTER RESECTION OF PROPER HEPATIC ARTERIAL ANEURYSM IN ONE PATIENT

Abstract

A 72-year-old woman was found to have a proper hepatic arterial aneurysm on CT scan for preoperative evaluation of ascending colon cancer. Follow-up CT scan confirmed the aneurysm's enlargement. Transcatheter arterial embolization (TAE) for the aneurysm was not performed because of risk of rupture. Resection of the aneurysm was completed with right and left hepatic arteries on the distal side, and common hepatic and gastroduodenal arteries on the proximal side. After ligation of the left and common hepatic arteries, the right hepatic artery was anastomosed to the gastroduodenal artery for hepatic arterial reconstruction. Postoperative doppler ultrasonography showed adequate blood flow to the right hepatic artery. The postoperative hematological examination demonstrated no severe hepatic injury. Three months later, angiography showed patency of the anastomotic site with no stenosis. Although the incidence of performing TAE for hepatic arterial aneurysm has been increasing, there was significant risk of rupture during this procedure. Resection of the aneurysm is thought to be the optional treatment for this disease.