Journals / Diagnostic and Interventional Radiology / 2016 / Cilt: 22 - Sayı: 4

Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

Pages
371–377
DOI
—
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The overall clinical success rate of TAE was 100% in all patients.

📌 3 Key Takeaways

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Objective & Hypothesis:PURPOSE We aimed to evaluate the imaging features of computed tomography (CT) and angiography and the efficacy of transcatheter arterial embolization (TAE) in patients with hemobilia of different iatrogenic causes.
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Key Findings & Data:METHODS Thirty patients with hemobilia were divided into two groups according to their iatrogenic causes, i.e., group 1, 11 patients (36.7%) with transhepatic intervention and group 2, 19 patients (63.3%) with surgical procedures in the hilar area.
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Conclusion & Impact:The overall clinical success rate of TAE was 100% in all patients.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

PURPOSE We aimed to evaluate the imaging features of computed tomography (CT) and angiography and the efficacy of transcatheter arterial embolization (TAE) in patients with hemobilia of different iatrogenic causes. METHODS Thirty patients with hemobilia were divided into two groups according to their iatrogenic causes, i.e., group 1, 11 patients (36.7%) with transhepatic intervention and group 2, 19 patients (63.3%) with surgical procedures in the hilar area. Seventeen patients (56.7%) underwent abdominal contrast-enhanced CT before selective angiography. Polyvinyl alcohol particles, gelatin sponges, and coils were used for TAE. Data from the two groups were compared using Fisher's exact test and the Mann-Whitney U test. RESULTS Contrast-enhanced CT showed a hematoma, extravasation of contrast material, and pseudoaneurysm. The bleeding source was determined by angiographic features in all patients, which were not significantly different between the two groups (P = 0.127), and pseudoaneurysm was the most common. The embolic material and number of coils used for TAE were significantly different between the two groups (P < 0.001), but the embolization was technically successful in all patients. The clinical success rate of the first embolization was 100% in group 1 vs. 84.2% in group 2. The overall clinical success rate of TAE was 100% in all patients. The complication rate was 63.6% in group 1 vs. 68.4% in group 2 (P = 1.000). CONCLUSION CT was useful in diagnosing hemobilia, and angiograms enabled determination of the bleeding source. Pseudoaneurysm was one of the most common angiographic features. TAE was successfully performed with different embolic materials on the basis of the iatrogenic cause and bleeding location.

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Cite This Article

FENG, W., YUE, D., MİNG, L. Z., ZHAO, L. Y., XUAN, Z. X., WEI, L., YONG, G. Q. (2016). Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients. Diagnostic and Interventional Radiology, Cilt: 22 - Sayı: 4, 371–377. https://ajindex.com/articles/350058

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References (5)

  1. Bloechle C, Izbicki JR, Rashed MY, et al. Hemo- bilia: presentation, diagnosis, and manage- ment. Am J Gastroenterol 1994; 89:1537-1540.
  2. Murugesan SD, Sathyanesan J, Lakshmanan A, et al. Massive hemobilia: a diagnostic and therapeutic challenge. World J Surgery 2014; 38:1755-1762. [CrossRef] Green MHA, Johnson CD, Jamieson NV. Hae- mobilia. Br J Surg 2001; 88:773-786. [CrossRef] Yoshida J, Donahue PE, Nyhus LM, et al. He- mobilia: review of recent experience with a worldwide problem. Am J Gastroenterol 1987; 82:448-453.
  3. Cao H, Liu J, Li T, et al. Interventional therapy for the treatment of severe hemobilia after per- cutaneous transhepatic cholangial drainage: a case series. International Surg 2013; 98:223- 228. [CrossRef] Hatzidakis A, Petrakis J, Krokidis M, et al. Hepat- ic artery aneurysm presenting with hemobilia in a patient with Behçet's disease: treatment with percutaneous transcatheteral emboliza- tion. Diagn Interv Radiol 2006; 12:53-55.
  4. Rhim H, Lim HK, Kim YS, et al. Hemobilia after ra- diofrequency ablation of hepatocellular carcino- ma. Abdom Imaging 2007; 32:719-724. [CrossRef] Srivastava DN, Sharma S, Pal S, et al. Transcath- eter arterial embolization in the management of hemobilia. Abdom Imaging 2006; 31:439- 448. [CrossRef] Xu ZB, Zhou XY, Peng ZY, et al. Evaluation of se- lective hepatic angiography and embolization in patients with massive hemobilia. Hepatobili- ary Pancreat Dis Int 2005; 4:254-258.
  5. Teng WS, Wu RH, Chang JM, et al. Transcatheter arterial embolization for hemorrhage caused by injury of the hepatic artery. J Gastroenterol Hepatol 2005; 20:1062-1068. [CrossRef] Nicholson T, Travis S, Ettles D, et al. Hepatic artery angiography and embolization for hemobilia following laparoscopic cholecystectomy. Cardio- vasc Intervent Radiol 1999; 22:20-24. [CrossRef] Rivera-Sanfeliz GM, Assar OS, LaBerge JM, et al. Incidence of important hemobilia following transhepatic biliary drainage: left-sided versus right-sided approaches. Cardiovasc Intervent Radiol 2004; 27:137-139. [CrossRef] Hemp JH, Sabri SS. Endovascular management of visceral arterial aneurysms. Tech Vasc Interv Radiol 2015; 18:14-23. [CrossRef] Walter JF, Paaso BT, Cannon WB. Successful transcatheter embolic control of massive he- matobilia secondary to liver biopsy. AJR Am J Roentgenol 1976; 127:847-849. [CrossRef] Sacks D, McClenny TE, Cardella JF, et al. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 2003; 14:S199- 202. Choi SH, Gw