Two days after laparoscopic cholecystectomy, a complete loss injury to the right hepatic artery and a Strasberg E3 bile duct injury with signs of liver ischaemia were found at surgical revision. A hepaticojejunal anastomosis was performed and a reversed great saphenous vein bypass was sutured end to end (asterisks) between a distally ligated and transposed gastroduodenal artery (GDA) and the hilar part of the right hepatic artery (dashed lines).
This technique circumvents anastomoses of the proper hepatic artery (PHA), complications of which may compromise blood supply to both hepatic arteries. The post-operative course was uncomplicated, and at discharge computed tomography angiography showed a patent bypass.