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  • Title: Hepatic artery angiography and embolization for hemobilia after hepatobiliary surgery.
    Author: Peng Z, Yan S, Zhou X, Xu Z.
    Journal: Chin Med J (Engl); 2001 Aug; 114(8):803-6. PubMed ID: 11780354.
    Abstract:
    OBJECTIVE: To evaluate the effectiveness of hepatic angiography and embolization in the diagnosis and treatment of hemobilia after hepatobiliary surgery. METHODS: Nine patients had upper gastrointestinal bleeding 7 days to 3 months after surgery. They underwent emergency hepatic artery angiography and were treated by embolization using Gelfoam particles only (8 patients) and Gelfoam particles plus microcoils (1 patient). RESULTS: Hepatic artery angiography revealed hepatic artery pseudoaneurysms in 3 patients, diffuse hemorrhage of the hepatic artery branches in 3, right hepatic artery-bile duct fistulas in 2, and hepatic artery-small intestine fistula in 1. Hemobilia was controlled with embolization in 7 patients, of whom 1 had recurrent bleeding 1 day after treatment. During the follow-up, 3 patients died of multiple organ dysfunction syndrome. Two patients whose hemorrhage could not be controlled due to technical reasons died several days later. CONCLUSION: When hemobilia after hepatobiliary surgery is suspected, patients should receive hepatic angiography as a first diagnostic procedure and be treated with minimally invasive procedure of selective embolization of the involved artery as soon as possible.
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