胆胰术后出血的介入治疗

目的探讨介入治疗胆胰术后出血的对策、方法选择和影响疗效的因素。方法对14例胆胰术后出血,分别采用明胶海绵条、钢圈、PVA颗粒进行栓塞或血管加压素局部灌注治疗。结果14例中发现16处病灶,进行了16次治疗。其中3次钢圈栓塞,6次PVA栓塞,2次明胶海绵栓塞,1次PVA 明胶海绵栓塞,4次血管加压素灌注。15次止血成功,1次因吻合口断裂血管加压素灌注止血无效,止血成功率93.8%。结论胆胰术后出血的介入治疗是安全而有效的治疗方法。对靶血管正确的选择栓塞或血管加压素局部灌注治疗是成功的关键。

Interventional treatment for hemorrhage following biliary and pancreatic surgery

Objective To study the tactics, methods and relevant factors of interventional treatment for hemorrhage following biliary and pancreatic surgery.Methods Fourteen patients with hemorrhage following biliary and pancreatic surgery were treated by embolization using gelfoam pledgets, PVA granules, metal coils or otherwise by local infusion of vasopressin. Results There were 16 foci in 14 patients with 16 times of interventional treatment, including 3 times using metal coils, 6 times of PVA, 2 gelfoam pledgets, 1 with PVA plus gelfoam pledgets, and 4 of vasopressin. There was 1/16 time failure of using vasopressin due to anastomotic rupture. The successful rate reached 93.8%. Conclusions Interventional treatment is a safe and effective method for hemorrhage following biliary and pancreatic surgery. The key of success is the right selection of embolization or vasopressin infusion for target artery.