Table 1 Vascular coil migration from right hepatic artery to common bile duct
From: Vascular coil erosion into hepaticojejunostomy following hepatic arterial embolisation
Author | Age/sex | Primary operation | Timing of RHApA bleed post-primary operation | Management of bleed | Time after which vascular coils migrated to CBD | Presenting symptom | Management |
|---|---|---|---|---|---|---|---|
Current study | 38 M | Bile Duct Reconstruction after BDI following cholecystectomy | 1 week | Required one attempt at coil embolisation “packing technique” with flow maintained within the artery. | 10 months | Obstructive jaundice and Cholangitis | 3 attempts with PTC to traverse biliary obstruction failed, bilateral biliary catheter drainage, and re-operation to revise hepaticojejunostomy |
Van Steenbergen et al. [22] | 72 M | Liver transplantation for primary biliary cirrhosis | 10 weeks | Coil embolisation “packing technique” with flow maintained within the artery. Bleeding recurred with revascularization of aneurysm. ePTFE covered coronary stent placed to exclude pseudoaneurysm | 5 years | Stone and coils in bile duct, described as “biliary colic” | ERCP (failed removal), coils and stone removed with PTC |
AlGhamdi et al. [23] | 55 F | Liver transplant for Hepatitis C cirrhosis and hepatocellular carcinoma | 13 weeks post-transplant, (had 2 balloon angioplasties of hepatic artery jump graft 10 weeks post-transplant for stenosis) | Embolisation of bleeding aneurysm, and balloon covered stent used to treat hepatic artery stenosis. Further small pseudoaneurysm at junction of hepatic artery and jump graft managed with coil packing and further covered stent to exclude pseudoaneurysm. | 3 months | Coil migration identified at time of biliary stent replacement for biliary stricture. | Coils and stones removed at ERCP with further balloon dilatation of stricture. |
Turaga et al. [27] | 65 M | Difficult cholecystectomy for gangrenous GB with T-tube choledochotomy after failed CBD stone retrieval | 3 weeks | Required one attempt at embolisation | 1 year | Obstructive jaundice and Cholangitis | ERCP (failed removal) ➔ required open bile duct exploration, removal of coils and insertion of T-tube. Artery and pseudoaneurysm ligated |
Kao et al. [28] | 65 F | Cholecystectomy and T-tube choledochostomy | Not reported | Coil embolisation | 8 years | Obstructive jaundice | PTC performed for biliary drainage followed by ERCP for removal of coils and stone from CBD |
Ozkan et al. [14] | 58 M | Subtotal Cholecystectomy for cholecystitis | 4 weeks, Required 2 attempts at embolisation | Coil embolisation, “packing technique” with flow maintained within the artery. Required further embolisation 3 days later for rebleed, and growth of neck of pseudoaneurysm | 2 years | Pancreatitis | ERCP identified coils ➔ required open bile duct exploration, removal of coils and stones, and drainage of pseudocyst with cystojejunostomy |