Moodley J, Singh B, Lalloo S, Pershad S, Robbs J V
Department of General Surgery, University of Natal, Durban, South Africa.
Br J Surg. 2001 Aug;88(8):1073-6. doi: 10.1046/j.0007-1323.2001.01825.x.
The aim was to evaluate a non-operative approach to the management of haemobilia.
This was a retrospective analysis of patients presenting over 10 years with haemobilia. All patients had upper gastrointestinal endoscopy, abdominal ultrasonography and digital subtraction angiography. Superselective coil and/or Gelfoam embolization was done as close as possible to the bleeding site. Completion angiography was performed routinely to confirm adequate embolization.
There were 23 patients with liver trauma and six with inflammatory conditions. All patients required resuscitation with fluids and blood transfusion, and had the haemobilia controlled successfully by angiographic embolization. There was one death from fulminant hepatic sepsis.
This series attests to the efficacy of a non-operative approach to haemobilia using radiological diagnosis and intervention.
目的是评估一种非手术方法治疗胆道出血。
这是一项对10余年间出现胆道出血患者的回顾性分析。所有患者均接受了上消化道内镜检查、腹部超声检查和数字减影血管造影。尽可能在靠近出血部位进行超选择性弹簧圈和/或明胶海绵栓塞。常规进行血管造影以确认栓塞充分。
有23例肝外伤患者和6例炎症性疾病患者。所有患者均需要液体复苏和输血，并通过血管造影栓塞成功控制了胆道出血。有1例死于暴发性肝脓毒症。
本系列证明了采用放射学诊断和干预的非手术方法治疗胆道出血的有效性。
