Clinical value of interventional diagnosis and treatment of massive hemobilia

doi:10.3877/cma.j.issn.2095-5782.2021.01.005

Abstract

Abstract:

Objective

To investigate the clinical value of interventional therapy for massive hemobilia.

Methods

The clinical data of 11 patients with massive hemobilia were collected, the causes of the hemobilia were analyzed, examination and treatment methods were analyzed, and the efficacy and safety were evaluated.

Results

Nine of the 11 patients had iatrogenic hemobilia, accounting for 81.82% (9/11). There were 4 cases of biliary surgery, 5 cases of bleeding after PTBD, and 3 cases of hepatic artery injury after PTBD. Among the 11 patients, 9 patients underwent selective embolization immediately after the diagnosis of massive hemobilia by digital subtraction angiography (DSA), and the success rate of hemostasis was 88.89% (8/9). There were no serious complications such as liver abscess and liver failure.

Conclusions

Iatrogenic injury is the main cause of massive hemobilia. Hepatic arteriography and embolization can diagnose and treat the fatal massive hemobilia quickly.

Key words: Massive hemobilia, Interventional radiology, Embolization, Diagnosis and treatment

Dong Lu, Senlin Chu, Yijiang Zhu, Delei Cheng, Jie Chai, Weifu Lv. Clinical value of interventional diagnosis and treatment of massive hemobilia[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(01): 31-35.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2021.01.005

https://zhjrfsxdzzz.cma-cmc.com.cn/EN/Y2021/V09/I01/31

Figures/Tables 2

References 16

[1]	Tanaka T, Takakura K, Maruyama Y, et al. Hemobilia derived from cystic artery pseudoaneurysm[J]. Case Rep Gastroenterol, 2019, 13(1): 89-94.
[2]	Murugesan SD, Sathyanesan J, Lakshmanan A, et al. Massive hemobilia: a diagnostic and therapeutic challenge[J]. World J Surg, 2014, 38(7): 1755-1762.
[3]	Staszak JK, Buechner D, Helmick RA. Cholecystitis and hemobilia[J]. J Surg Case Rep, 2019, (12): rjz350.
[4]	Zhou HB. Hemobilia and other complications caused by percutaneous ultrasound-guided liver biopsy[J]. World J Gastroenterol, 2014, 20(13): 3712-3715.
[5]	Bacalbasa N, Brezean I, Anghel C, et al. Management ofa fulminant upper gastrointestinal bleeding exteriorized through hemobilia due to arteriobiliary fistula between the common bile duct and a right hepatic artery aneurysm - a case report[J]. In Vivo, 2017, 31(5): 983-989.
[6]	Alrajraji M, Nawawi A, Jamjoom R, et al. Delayed hemobilia due to hepatic artery pseudo-aneurysm: a pitfall of laparoscopic cholecystectomy[J]. BMC Surg, 2016, 16(1): 59.
[7]	Santos T, Serra M, Oliveira A, et al. Dieulafoy lesion of the gallbladder: a rare cause of hemobilia and acute pancreatitis - case report[J]. Int J Surg Case Rep, 2020, 66: 207-210.
[8]	Hamada T, Yasunaga H, Nakai Y, et al. Severe bleeding after percutaneous transhepatic drainage of the biliary system: effect of antithrombotic agents--analysis of 34 606 cases from a Japanese nationwide administrative database[J]. Radiology, 2015, 274(2): 605-613.
[9]	Zhang DS, Metwalli Z, Hussain KB. Arterial-portal fistula after percutaneous liver biopsy in hepatic allograft causing hemobilia and pancreatitis[J]. Clin Gastroenterol Hepatol, 2017, 15(1): e3-e4.
[10]	Lee SH, Hong SG, Lee KY, et al. Delayed severe hemobilia after endoscopic biliary plastic stent insertion[J]. Clin Endosc, 2016, 49(3): 303-307.
[11]	Choi SH, Gwon DI, Ko GY, et al. Hepatic arterial injuries in3 110 patients following percutaneous transhepatic biliary drainage[J]. Radiology, 2011, 261(3): 969-975.
[12]	Puntel G, Puppini G, Perandini S, et al. Diagnosis and management of iatrogenic hemobilia secondary to transjugular intrahepatic portosystemic shunt procedure[J]. Cureus, 2020, 12(4): e7629.
[13]	Zhu JY, Huang J, Fan W, et al. Massive hemobilia due to a ruptured mycotic hepatic artery aneurysm associated with streptococcal endocarditis: case report[J]. J Int Med Res, 2020,48(3): 300060519883554.
[14]	Ayoola R, Jamindar P, Williams R. Venobiliary fistula with haemobilia: a rare complication of percutaneous liver biopsy[J]. BMJ Case Rep, 2017, bcr2016218930.
[15]	Hong DP, Xuan DP, Quang HH. Post-blunt traumatic hemobilia from pseudoaneurysm successfully treated with embolization[J]. Cureus, 2020, 12(5): e7961.
[16]	Wang XJ, Buttar N, Storm AC. Management of hemodynamic collapse after liver transplantation from native bile duct stump hemorrhage with gelfoam[J]. ACG Case Rep J, 2019, 6(10): e00254.

Please choose a citation manager

Content to export