Dürig M, Tondelli P, Harder F, Rüedi T P, Vokal J
Langenbecks Arch Chir. 1978 Apr 7;344(4):271-9. doi: 10.1007/BF01261265.
A case of traumatic hemobilia is reported. After ligation of the left hepatic artery and additional dearterialisation a third bleeding period occured due to a porto-hepatic communication, diagnosed by a transumbilical portography. A left hepatic lobectomy was finally necessary to achieve hemostasis. This case demonstrates that a selective artery ligation for the treatment of hemobilia is only successful if a complete dearterialisation is performed at the first operation. Furthermore a porto-hepatic communication may require partial hepatectomy.
报告了一例创伤性血胆症病例。在结扎左肝动脉并进行额外的去动脉化后，由于门静脉-肝内交通支导致了第三次出血期，通过经脐门静脉造影得以诊断。最终需要进行左肝叶切除术来实现止血。该病例表明，选择性动脉结扎治疗血胆症只有在首次手术时进行彻底的去动脉化才会成功。此外，门静脉-肝内交通支可能需要进行部分肝切除术。
