Interventional therapy for the treatment of severe hemobilia after percutaneous transhepatic cholangial drainage: a case series

Int Surg. 2013 Jul-Sep;98(3):223-8. doi: 10.9738/INTSURG-D-13-CC194.

Abstract

From May 2003 to May 2010, a total of 9 patients with severe hemobilia after percutaneous transhepatic cholangial drainage (PTCD) were diagnosed using superselective angiography and cholangiography, and then were treated with interventional procedures. Two patients with hepatic arterio-biliary fistula underwent proximal and distal arterial embolization of the responsible vessel. Six patients with pseudoaneurysm had pseudoaneurysm occlusion with proximal and distal embolization. Another patient with biliary-portal vein fistula received a biliary fully covered stent placement. The effects in these patients were evaluated using superselective angiography immediately after the intervention and at 3- and 6-month follow-up. In all patients, hemobilia was stopped right after the treatment and no sign of recurrence was noted at 3- and 6-month follow-up after the interventional therapy. Our findings demonstrate that interventional therapy is a simple, minimally invasive, and safe approach for treating severe hemobilia in patients receiving PTCD.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Drainage / adverse effects*
  • Embolization, Therapeutic / methods*
  • Female
  • Hemobilia / diagnostic imaging
  • Hemobilia / etiology
  • Hemobilia / therapy*
  • Humans
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / therapy*
  • Male
  • Middle Aged
  • Radiography
  • Treatment Outcome