胆道大出血的血管造影诊断及介入治疗(附20例报道)

The Value of Angiography and Embolization in the Diagnosis an Treatment to the Massive Hemobilia ( Reported of 20 Cases)

目的评价血管造影诊断及介入治疗在胆道大出血中的价值。方法对20例胆道大出血病人采用介入放射技术紧急行腹腔动脉和肝动脉造影,明确出血部位后,行肝动脉分支出血点栓塞术。结果20例栓塞后出血均立即停止,2例再发出血,经再次栓塞后也成功止血。随访6月～2年均无再出血及并发症发生。结论选择性肝动脉造影和栓塞术对胆道大出血诊断准确,止血效果确切,简单易行,安全可靠,比手术具有显著优点,应作为首选方法。

Objective To evalute the value of angiography and embolization in the diagnosis an treatment to the massive hemobilia. Methods 20 patients with massive hemobilia underwent emergency celiac and hepatic artery angiography. The patients were diagnosed rapidly and treated successfully by embolization of the hepatic artery branch proximal to the bleeding point. Results Hemorrhage of all patients was stopped immediately, 2 patients were embolized two times for bleeding again. All of patients were alive and followed up for 6 months to 2 years. There are not bleeding and no ser/ous complication. Conclusion As a safe, reliable,simple method. Selective hepatic artery angiography and embolization which had obvious advantages than surgery. It should be the first choice for the massive hemobilia.