Transcatheter arterial embolization for iatrogenic hemobilia is a safe and effective procedure

Abstract

The delay between the intervention and the clinical presentation and the fact that imaging studies may fail to diagnose hemobilia may mislead the physician. Transcatheter arterial embolization is the treatment of choice for hemobilia. It has proven to be effective and safe and it offers a long-term definitive cure.

Hemobilia related to cystic artery pseudoaneurysm as a cause of acute pancreatitis

“…If bile duct obstruction by hemobilia occurs, it may cause pancreatitis. Gold standard treatment is selective transarterial embolization (3,5). In conclusion, we would like to emphasize that acute biliary symptoms combined with UGIB should strongly suggest the possibility of hemobilia, which involves high mortality rates without specific treatment.…”

“…Tumors, gallstones and vascular or inflammatory diseases may also cause hemobilia (1,2). Hemobilia classically presents with the Quincke triad (abdominal pain, obstructive jaundice and UGIB) (1,3,4). If bile duct obstruction by hemobilia occurs, it may cause pancreatitis.…”

Direct puncture embolization using N-butyl cyanoacrylate for a hepatic artery pseudoaneurysm

“…Transcatheter embolization is a well-established treatment for ruptured pseudoaneurysm (2)(3)(4), but previous intervention may make the pseudoaneurysm inaccessible by the transcatheter approach (5)(6)(7)(8)(9)(10). Embolization of pseudoaneurysms by direct puncture has been described previously in the literature as an alternative to the transcatheter approach (5)(6)(7)(8)(9)(10)(11).…”

“…Massive hemobilia caused by hepatic artery pseudoaneurysm is an uncommon but fatal complication that can occur after biliary intervention (1,2). Transcatheter embolization is a well-established treatment for ruptured pseudoaneurysm (2)(3)(4), but previous intervention may make the pseudoaneurysm inaccessible by the transcatheter approach (5)(6)(7)(8)(9)(10).…”

Identification of risk factors for intraoperative hemobilia and its correlation with early postoperative complications in patients with hepatolithiasis

“…[2][3][4] Most studies of hemobilia have concentrated on iatrogenic trauma resulting from either diagnostic or therapeutic procedures, such as percutaneous liver biopsy, transhepatic cholangiography, endoscopic retrograde cholangiopancreatography (ERCP), and so on, among which incidence of hemobilia has risen considerably. [5][6][7] Intraoperative hemobilia is also frequently encountered during hepatolithiasis surgery.…”