医源性肝动脉损伤及假性肝动脉瘤的诊断与急救方法探讨

Methods of diagnosis and emergency treatment of iatrogenic hepatic artery injury and pseudoaneurysm formation

目的 探讨因胆囊切除或胆道探查所致肝动脉损伤及假性肝动脉瘤的诊断与急救方法。方法 总结了近年来收治的肝动脉损伤６ 例，其中４ 例已形成假性动脉瘤，手术行肝动脉结扎治疗，其余２ 例为单纯肝动脉损伤，行经皮肝动脉栓塞治愈。结果 ６ 例中５ 例痊愈，１ 例死于再出血。结论 血管造影是目前本病诊断较为准确可靠的方法之一，肝动脉结扎是本病治疗的传统术式，经皮肝动脉栓塞具有创伤小、疗效可靠等优点。

Objective To inquire into methods of diagnosis and emergency treatment of hepatic artery injury and pseudoaneurysm formation due to cholecystectomy and choledocholithotomy. Methods Six cases of iatrogenic hepatic artery injury were treated by surgical operation and hepatic artery embolization. Four of them with pseudoaneureysm formation were treated with hepatic artery ligation, and the other two cases with simple hepatic injury were treated with embolization. Results Five cases were fully recovered and one case died from shock due to secondary hemobilia. Conclusion Angiography is a reliable method of diagnosis; hepatic artery ligation is a traditional operation way; and percutaneous hepatic artery embolization is associated with minimal trauma and reliable curative effect.