采用肝动脉双重栓塞法治疗肝胆手术后胆管出血的临床探讨

Comprehensive analysis of double hepatic artery embolization in treating post-operative hematobilia of patients underwent hepatobiliary surgery

目的肝胆手术后胆道出血患者进行肝动脉双重栓塞治疗的临床效果分析。方法选择于2005年11月至2011年8月在我院行肝胆手术后胆道出血患者39例(其中行保守治疗者20例,利用Seldinger技术选择出血区的远、近端行供血动脉双重栓塞治疗患者19例),回顾性比较患者住院期间各项指标。结果保守治疗组患者治愈3例,死亡3例,14例患者接受再次手术;双重动脉栓塞组患者治愈18例,1例患者再次手术,无死亡患者。保守治疗患者中2例出现3处止血失败,介入治疗患者无严重并发症。结果肝胆手术后患者胆管出血采用双重动脉栓塞介入治疗,止血确实可靠,方法简单,无需进行复杂麻醉,且临床并发症少。

Objective To explore the application of doable hepatic artery embolization in post-operative hematobilia of patients underwent hepatobiliary surgery. Methods Comparing the treatment and clinical outcomes of patients underwent hemato- bilia post-hepatobiliary surgery （20 patients accepted expectant treatment, while 19 cases were treated with hepatic artery double embolization） during November 2005 to August 2011 retrospectively. Results Hepatic artery double embolization cured 18/19 patients （ 1 cases died） without severe complications. However, there were 14 patients suffered from reoperation and 3 died, only 3 were cured in the expectant treatment group. Conclusion Hepatic artery double embolization is a simple but reliable method to treat patients underwent hematobilia post-hepatobiliary surgery without complex anesthesia and complications.