胆道大出血20例临床回顾分析

Massive hemobilia., a clinical study of 20 patients

目的探讨胆道大出血的病因、诊断与治疗。方法对1998年8月至2008年8月收治的20例胆道出血临床资料作回顾分析。结果20例均经保守治疗，4例治愈，7例行肝动脉血管造影术与栓塞术，6例止血成功，1例失败，后经手术治疗痊愈。共有10例经保守治疗无效后手术治疗，均未发生再出血，无死亡病例。结论在条件允许情况下，肝动脉血管造影与栓塞是术后胆道出血诊断治疗的首选，如果非手术治疗无效或栓塞疗法失败，则应积极手术治疗。

Objective To investigate the etiology, diagnosis and choice of treatment for massive hemobilia. Methods A retrospective analysis was made on the clinical data of 20 patients with massive hemobilia treated from August 1998 to August 2008. Results Initially conservative therapy was used on 20 patients and bleeding stopped in 4 patients. For the seven patients who were treated with hepatic artery angiography and embolization, bleeding stopped in 6 patients. 10 patients were treated by operation and bleeding stopped in all these patients. No patient died in this series. Conclusions Hepatic artery angiography and embolization should be used to treat patients with massive hemobilia. Surgery should be offered if conservative therapy and hepatic artery embolization fail.