Yoshida J, Donahue P E, Nyhus L M
Am J Gastroenterol. 1987 May;82(5):448-53.
Between 1981 and 1985, the reported incidence of hemobilia increased for two major reasons. First, a more sophisticated and better-trained medical community could entertain the diagnosis readily in certain settings and had broader access to diagnostic methods that precisely defined the source of bleeding into the biliary tract. Second, there was wider use of percutaneous techniques of diagnosis and treatment of biliary diseases. Once the diagnosis of hemobilia was made by endoscopic or arteriographic means, physicians and surgeons were quicker to institute proper therapeutic measures. For this reason, the mortality associated with hemobilia decreased compared with that reported earlier. The medical community must be aware that modern treatments are now the most common cause of this problem. Since invasive diagnostic methods are increasingly used by nonsurgeons, it is imperative that these patients are studied in the context of complete consultation with surgeons who can use definitive treatments when required.
1981年至1985年间，报道的胆道出血发病率上升有两个主要原因。首先，医疗界更加成熟且训练有素，在某些情况下能够轻易考虑到该诊断，并且有更广泛的途径使用能精确确定胆道出血来源的诊断方法。其次，胆道疾病的经皮诊断和治疗技术得到了更广泛的应用。一旦通过内镜或血管造影手段做出胆道出血的诊断，内科医生和外科医生会更快地采取适当的治疗措施。因此，与胆道出血相关的死亡率与早期报道相比有所下降。医学界必须意识到，现代治疗方法如今是这个问题最常见的病因。由于非外科医生越来越多地使用侵入性诊断方法，必须在与外科医生进行全面会诊的背景下对这些患者进行研究，外科医生可以在需要时采用确定性治疗方法。
