Interventional diagnosis and management of patients with hemobilia (A report of 3 cases) / 中国微创外科杂志

ABSTRACT

Objective To evaluate the value of vascular intervention in the diagnosis and management of hemobilia. Methods With Seldinger's technique ,digital subtraction angiography of superior mesenteric artery and hepatic arteriography were performed on 3 patients with hemobilia, two of whom manifested hemobilia after the operation of liver trauma and one of whom did after the operation of command bile duct stones . Arteriography showed the bleeding vascular branch, the false aneurysm and the arteriovenous fistula. And then a small catheter was put into the bleeding focus. The bleeding branch arteries were selectively embolized with embolus of n-butyl cyanoacrylate (NBCA),PVA granule,spring wire loop and gelatin sponge. Results Two cases showed diffuse bleeding focus and another showed a local bleeding focus. Two cases had expression of false aneurysm and one showed expression of ateriovenous fistula. The artery branches of the bleeding focus were successfully embolizated and the hemobilia stopped immediately. Conclusions Vascular intervention is an effective method for the diagnosis and management of hemobilia.