Laparoscopic management of a ruptured cystic artery pseudoaneurysm secondary to biliary adenocarcinoma: Technical challenges and implications for surgical training

Ricardo Marinho; Monica Laureano; Maria Fernanda Cunha; Miguel Castelo-Branco Sousa; Antonello Forgione; Mário Rui Gonçalves

doi:10.1016/j.lers.2026.04.004

May 1, 2026Laparoscopic Endoscopic and Robotic SurgeryOpen Access

Laparoscopic management of a ruptured cystic artery pseudoaneurysm secondary to biliary adenocarcinoma: Technical challenges and implications for surgical training

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Key Points

This research aims to address the technical challenges of laparoscopic management for ruptured cystic artery pseudoaneurysms associated with biliary adenocarcinoma.
Conducted a laparoscopic procedure to manage the rupture of a cystic artery pseudoaneurysm
Implemented a structured fundus-first approach for vascular control
Utilized simulation-based training to prepare for surgical challenges
The emergency management of the pseudoaneurysm was feasible despite high difficulty (Nassar Grade IV)
A structured approach significantly improved safety in achieving vascular control
Simulation-based training demonstrated effectiveness in enhancing readiness for rare biliary emergencies

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Implication

Explores laparoscopic management of ruptured cystic artery pseudoaneurysm, suggesting improved surgical preparedness in rare biliary emergencies.

Abstract

• Ruptured cystic artery pseudoaneurysm causing haemoperitoneum is rare • Ruptured cystic artery pseudoaneurysm rupture may reveal underlying biliary adenocarcinoma • Emergency laparoscopy management is feasible despite Nassar Grade IV difficulty • A structured fundus-first strategy enables safe vascular control • Simulation-based training may improve preparedness for rare biliary emergencies

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Marinho et al. (2026) studied this question.

synapsesocial.com/papers/69fed0e2b9154b0b82877f9c https://doi.org/10.1016/j.lers.2026.04.004

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Laparoscopic management of a ruptured cystic artery pseudoaneurysm secondary to biliary adenocarcinoma: Technical challenges and implications for surgical training

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Laparoscopic management of a ruptured cystic artery pseudoaneurysm secondary to biliary adenocarcinoma: Technical challenges and implications for surgical training

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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