Causes and countermeasures of delayed hemobilia after endoscopic retrograde cholangiopancreatography
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摘要: 目的探讨经内镜逆行胰胆管造影(ERCP)术后迟发性胆道出血的原因和应对措施。方法回顾性分析1007例行ERCP的术后并发症,7例为迟发性胆道出血,对出血时间、疾病谱、出血量和治疗过程进行分析。结果出血患者均存在胆管炎症,出血时间在术后24 h至2周,出血量为少量至中等量(≤1000 ml),内科保守治疗效果良好。结论 ERCP术后迟发性胆道出血临床罕见,内科保守治疗预后良好。
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关键词:
- 胆道出血 /
- 胰胆管造影术,内窥镜逆行 /
- 括约肌切开术,内窥镜
Abstract: Objective To investigate the cause and treatment of delayed hemobilia after endoscopic retrograde cholangiopancreatography ( ERCP) . Methods A retrospective analysis was performed on the complications in 1007 patients after ERCP, and the 7 cases of delayed hemobilia were subjected to analysis of time of onset of bleeding, spectrum of disease, blood volume, and treatment process. Results All the bleeding patients had cholangitis. The bleeding occurred at 24 hours to 2 weeks after ERCP, with a small to medium volume of blood ( ≤1000 ml) . The conservative medical treatment produced a good outcome in these bleeding patients. Conclusion Delayed hemobilia after ERCP is rare and has a good prognosis following conservative medical treatment. -
[1]YANG Z, MA SR.Diagnostic and therapeatic skills of ERCP on common cholangiopancreatic diseases[J].J Clin Hepatol, 2012, 28 (2) :84-87. (in Chinese) 杨卓, 麻树人.常见胆胰疾病经内镜逆行胰胆管造影诊治技巧[J].临床肝胆病杂志, 2012, 28 (2) :84-87. [2] GUO XG, WU KC.Endoscopic retrograde cholangiopancreatography[M].Beijing:People's Military Medical Press, 2009. (in Chinese) 郭学刚, 吴开春, 译.内镜逆行胰胆管造影.北京:人民军医出版社, 2009:46-55. [3]GREEN MH, DUELL RM, JOHNSON CD, et al.Haemobilia[J].Br J Surg, 2001, 88 (6) :773-786. [4]CHIN MW, ENNS R.Hemobilia[J].Curr Gastroenterol Rep, 2010, 12 (2) :121-129. [5]GANDHI V, DOCTOR N, MARAR S, et al.Major hemobilia–experience from a specialist unit in a developing country[J].Trop Gastroenterol, 2011, 32 (3) :214-218. [6]GHOLSON F, FAVROT D, VICKERS B, et al.Delayed hemorrhage following endoscop ic retrograde sphincterotomy for choledocholithiasis[J].Dig Dis Sci, 1996, 41 (5) :831-834. [7]KIM KH, KIM TN.Etiology, Clinical features, and endoscopic management of hemobilia:a retrospective analysis of 37 cases[J].Korean J Gastroenterol, 2012, 59 (4) :296-302. [8]BLOECHLE C, LZBICKI JR, RASHED MY, et al.Hemobilia:presentation, diagnosis, and management[J].Am J Gastroenterol, 1994, 89 (9) :1537-1540. [9]WILLEMSEN PJ, VANDERVEKEN ML, de CALUWE DO, et al.Hemobilia:a rare complication of cholecystitis and cholecystolithiasis.Case report[J].Acta Chir Belg, 1996, 96 (2) :93-94. [10]MARYNISSEN T, MALEUX G, HEYE S, et al.Transcatheter arterial embolization for iatrogenic hemobilia is a safe and effective procedure:case series and review of the literature[J].Eur J Gastroenterol Hepatol, 2012, 24 (8) :905-909. [11]RHIM H, LIM HK, KIM YS, et al.Hemobilia after radiofrequency ablation of hepatocellular carcinoma[J].Abdom Imaging, 2007, 32 (6) :719-724. [12]LI JM, LI Y, WEI F.Exploration of risk factors and preventive measure for patients with bile-duct haemorrhage after ERCP[J].Med J West China, 24: (3) :600-602. (in Chinese) 李俊梅, 李芸, 魏芳.ERCP术后并发胆道出血的危险因素及防护[J].西部医学, 2012, 24 (3) :600-602. [13]ZHANG Y, CHEN SY.Evidence-based case discussion for postERCP hemobilia[J].Chin J Evid-based Med, 2005, 5 (10) :797-802. (in Chinese) 张颖, 陈世耀.ERCP术后胆道出血的循证病案讨论[J].中国循证医学杂志, 2005, 5 (10) :797-802. [14]SO YH, CHOI YH, CHUNG JW, et al.Selective embolization for post-endoscopic sphincterotomy bleeding:technical aspects and clinical efficacy[J].Korean J Radiol, 2012, 13 (1) :73-81. [15]MOODLEY J, SINGH B, LALLOO S, et al.Non-operative management of hemobilia[J].Br J Surg, 2001, 88:1073-1076.
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