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Introduction <p>Haemobilia is an uncommon yet important cause of uppergastrointestinal bleeding, most often iatrogenic after hepatobiliarymanipulation. The classic Quincke triad (jaundice, right-upper-quadrantpain, and upper GI bleeding) is infrequent, and contrast-enhancedcomputed tomography is pivotal for localization and planning. </p> Case Presentation <p>A 74-year-old woman presented with upper GI bleeding.Endoscopy revealed haemobilia without active spurting. Persistent anemiaprompted computed tomographic angiography (CTA), which showedactive bleeding into the gallbladder with signs of acute cholecystitis.Laparoscopic cholecystectomy was performed to control bleeding andtreat cholecystitis in a single procedure. On postoperative day 3,hemoglobin fell again. Repeat CTA identified active bleeding from anaberrant cystic artery within the remnant cystic duct. Percutaneousembolization with two coils achieved angiographic occlusion, yet anemiapersisted. Diagnostic laparoscopy revealed ongoing bleeding from theaberrant cystic artery; definitive hemostasis was obtained by ligation withtwo polymeric clips, along with hemoperitoneum drainage andlaparoscopic peritoneal lavage. The patient recovered without rebleeding.</p> Conclusions <p>This case highlights an unusual source of haemobilia—an aberrant cystic artery in the cystic-duct remnant—and underscores a stepwise strategy: prompt imaging for localization, minimally invasive control (endovascular) when feasible, and timely conversion to surgery when bleeding persists or when concomitant pathology (acute cholecystitis) warrants operative management. Maintaining bile flow while securing hemostasis remains central to reducing complications and achieving durable resolution.</p>

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Laparoscopic Approach of Hemobilia Secondary to Aberrant Cystic Artery: Case Report

  • 期刊论文

  • 发表日期：

    2026年2月28日

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  • Luis Felipe Cabrera Vargas,
  • Maria Paula Forero Rios,
  • Carolina Riscanevo,
  • Nicolas Forero Ramirez

摘要

Introduction

Haemobilia is an uncommon yet important cause of uppergastrointestinal bleeding, most often iatrogenic after hepatobiliarymanipulation. The classic Quincke triad (jaundice, right-upper-quadrantpain, and upper GI bleeding) is infrequent, and contrast-enhancedcomputed tomography is pivotal for localization and planning.

Case Presentation

A 74-year-old woman presented with upper GI bleeding.Endoscopy revealed haemobilia without active spurting. Persistent anemiaprompted computed tomographic angiography (CTA), which showedactive bleeding into the gallbladder with signs of acute cholecystitis.Laparoscopic cholecystectomy was performed to control bleeding andtreat cholecystitis in a single procedure. On postoperative day 3,hemoglobin fell again. Repeat CTA identified active bleeding from anaberrant cystic artery within the remnant cystic duct. Percutaneousembolization with two coils achieved angiographic occlusion, yet anemiapersisted. Diagnostic laparoscopy revealed ongoing bleeding from theaberrant cystic artery; definitive hemostasis was obtained by ligation withtwo polymeric clips, along with hemoperitoneum drainage andlaparoscopic peritoneal lavage. The patient recovered without rebleeding.

Conclusions

This case highlights an unusual source of haemobilia—an aberrant cystic artery in the cystic-duct remnant—and underscores a stepwise strategy: prompt imaging for localization, minimally invasive control (endovascular) when feasible, and timely conversion to surgery when bleeding persists or when concomitant pathology (acute cholecystitis) warrants operative management. Maintaining bile flow while securing hemostasis remains central to reducing complications and achieving durable resolution.