Operative Repair of Hepatic Artery Aneurysm

Abstract

ANEURYSM of the hepatic artery is rarely encountered, only 154 cases having been reported to date. While only four patients had successfully undergone surgical repair prior to 1951, vascular techniques have improved the previous grave prognosis. Ligation, endo-aneurysmorrhaphy, excision and reanastomosis of the hepatic artery, splenohepatic anastomosis, synthetic vessel substitution, cellophane wrapping, and intraaneurysmal wiring have been successful. There have been 43 patients reported who have been cured using these methods (Table 1). Eighty percent of the cases are initially seen after rupture of the aneurysm.¹Many of those which have not yet ruptured are first diagnosed at operation. The infrequency of preoperative diagnosis and the critical condition of the patient following rupture usually preclude the use of elaborate operative methods or adjuncts such as hypothermia. Reconstructive endo-aneurysmorrhaphy is simple, safe, gives immediate control of hemorrhage, and preserves hepatic arterial supply. The following case report illustrates the use of