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Value of MRI in three patients with major vascular injuries after laparoscopic cholecystectomy

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Abstract

The aim of this study was to describe three cases of major vascular injuries after laparoscopic cholecystectomy depicted on magnetic resonance (MR) examination. Three female patients (mean age, 32 years; range, 22–39 years) were studied with clinical suspicion of bilio-vascular injuries after laparoscopic cholecystectomy. All MR examinations were performed within 24 h after the laparoscopic procedure. MR imaging was evaluated for major vascular injuries involving the arterial and portal venous system, for bile duct discontinuity, presence or absence of biliary dilation, stricture, excision injury, free fluid and collections. In the first patient, a type-IV Bismuth injury with associated intrahepatic bile ducts dilation was observed. Contrast-enhanced MR revealed lack of enhancement in the right hepatic lobe due to occlusion of the right hepatic artery and the right portal branch. This patient underwent right hepatectomy with hepatico-jejunostomy. In the other two cases, no visualization of the right hepatic artery and the right portal branch was observed on MR angiography. In the first case, the patient underwent right hepatectomy; in the second case, because of stable liver condition, the patient was managed conservatively. MR imaging combined with MR angiography and MR cholangiography can be performed emergently in patients with suspicion of bilio-vascular injury after laparoscopic cholecystectomy allowing the simultaneous evaluation of the biliary tree and the hepatic vascular supply that is essential for adequate treatment planning.

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Acknowledgment

The authors sincerely thank Dr. Graciana Diez-Roux for critically reviewing this manuscript and Ciro Anatrella and Vincenzo Braun for their valuable technical assistance in making this study possible.

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Authors and Affiliations

  1. Departments of Radiology, Cardarelli Hospital and University “Federico II”, Via Pansini 5, Napoli, Italy

    Alfonso Ragozzino, Francesco Lassandro, Rosaria De Ritis & Massimo Imbriaco

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  1. Alfonso Ragozzino
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  2. Francesco Lassandro
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  3. Rosaria De Ritis
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  4. Massimo Imbriaco
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Corresponding author

Correspondence to Massimo Imbriaco.

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Ragozzino, A., Lassandro, F., De Ritis, R. et al. Value of MRI in three patients with major vascular injuries after laparoscopic cholecystectomy. Emerg Radiol 14, 443–447 (2007). https://doi.org/10.1007/s10140-007-0617-x

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  • DOI: https://doi.org/10.1007/s10140-007-0617-x

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