# Portal vein reconstruction in iatrogenic portal vein ligation

## TL;DR

A patient developed severe complications after a routine surgery, and was successfully treated with a novel endovascular approach to repair the damaged portal vein.

## Contribution

The paper presents a successful case of endovascular portal vein reconstruction using trans-splenic and right internal jugular vein access.

## Key findings

- Endovascular portal venous reconstruction successfully managed iatrogenic portal vein ligation.
- Trans-splenic and right internal jugular vein access enabled effective treatment of vascular injury.
- The case highlights a potential treatment strategy for rare but severe surgical complications.

## Abstract

Laparoscopic cholecystectomy for acute cholecystitis is one of the most performed surgeries and is generally regarded as a safe procedure with a low risk of complications. Vascular and biliary injuries are rare but have severe consequences. No systematic studies have been performed to delineate optimal treatment strategies in these scenarios, which are typically managed on a case-by-case basis. The present report describes a patient who underwent a laparoscopic cholecystectomy, complicated by common bile duct and main portal vein ligation, resulting in hepatic infarcts, perihepatic abscess, and portal hypertension with ascites and portomesenteric congestive enteropathy. This case focuses on management of this patient’s vascular injury, which was successfully treated by endovascular portal venous reconstruction using trans-splenic and right internal jugular vein access.