胆道大出血的介入放射学(附5例报告)

Interventional Radiology of Massive Hemobilia

5例医源性胆道大出血病例,均经皮经导管用明胶海绵或钢圈动脉栓塞止血成功。证实急诊腹腔动咏造影是胆道大出血最好的定位诊断方法。经皮经导管动脉栓塞治疗胆道大出血操作简便、疗效迅速可靠、并发症少,应作为首选的疗法。作者认为,动脉栓塞不一定非要置管于出血的分支动脉,只要无禁忌证,栓塞肝固有动脉及其分支亦安全可行。长期休克未纠正者也应作为胆道大出血肝动脉栓塞治疗的禁忌证。

This paper reports 5 cases of itrogenic massive hemobilia.The bleeding of all the patients was successfully controlled via transcatheter arterial embolization. Our experience has again proved that emergency arteriography is the best method to determine the bleeding site. Transcatheter arterial embolization is easy, rapid, safe, reliable and with minor complication method, and thus should be first choice for treating hemobilia. The embolization should be contraindicated in patients with long-term shock without correction. The contraindicatious include severe hepatic cirrhosis accompanied by liver dysfunction, portal hyperfension with flow impedance.