Abstract:Objective：To evaluate the hemostasis efficacy of selective artery embolization for treatment of patients with massive hemobilia.
Methods：Adopting the Seldinger technique, transcatheter selective arterial embolization was performed in twenty-three patients with massive hemobilia caused by liver trauma, hepatic calculus and hepatocellular carcinoma.
Results：Of the 23 cases, 12 cases had bleeding from right hepatic artery branch, 5 from left hepatic artery branch and 6 from both right and left hepatic artery branches as shown by digital subtraction angiography (DSA). Hepatic artery break off, false aneurysm，contrast medium overflow and bile duct display were the typical angiographic signs of the patients with massive hemobilia. There were twelve patients with single bleeding focus and eleven with multi-bleeding foci of hepatic artery branch. All patients successfully underwent selective artery embolization and the bleeding stopped immediately. There were no cases of rebleeding, no cases were converted to laparotomy and no mortality caused by hepatic artery embolization in this series; and all the 23 patients are well in a half to three years of follow-up.
Conclusions：Selective arterial embolization is an effective and simple hemostasis method for patients with massive hemobilia.
