胆总管空肠Roux-en-Y机械吻合术后吻合口出血的血管内栓塞治疗  

Endovascular embolization in managing anastomotic bleeding occurring after the stapled Roux-en-Y choledochojejunostomy

作　　者：李腾飞[1] 任建庄[1] 李臻[1] 张凯[1] 黄国灏 韩新巍[1] 焦德超[1] 

机构地区：[1]郑州大学第一附属医院放射介入科、介入治疗研究所,450052

出　　处：《介入放射学杂志》2015年第1期29-32,共4页Journal of Interventional Radiology

摘　　要：目的探讨血管内栓塞治疗胆总管空肠Roux-en-Y机械吻合术后吻合口出血的疗效和安全性。方法 16例经DSA检查证实胆总管空肠Roux-en-Y机械吻合术后吻合口出血患者,超选至病变责任供血动脉,采用血管内明胶海绵和(或)弹簧圈栓塞治疗,观察疗效,总结治疗经验。结果术中造影发现16例患者出血部位均位于机械吻合口处,并可见对比剂明显外溢,对其责任供血动脉进行超选并栓塞,术后患者腹腔留置引流管出血停止,实验室检查提示血红蛋白及红细胞计数未再下降。术中、术后均未出现与血管内治疗相关的并发症。结论血管内栓塞治疗是胆总管空肠Roux-en-Y机械吻合术后吻合口出血安全、有效的治疗手段。Objective To investigate the efficacy and safety of endovascular embolization in managing anastomotic bleeding occurring after stapled Roux- en- Y choledochojejunostomy. Methods A total of 16 patients with DSA- confirmed anastomotic bleeding which occurred after stapled Roux- en- Y choledochojejunostomy were enrolled in this study. Super- selective catheterization was employed to insert the catheter into the responsible artery, which was followed by embolization with Gelfoam particles and/or steel coils. The clinical results were analyzed and the experience was summarized. Results Angiography performed during the operation revealed that the bleeding site was located at the stoma in all 16 patients, and obvious extravasation of the contrast could be observed. Super- selective embolization of the bleeding artery was then carried out. After the treatment, abdomen drainage- tube was retained and the bleeding stopped.Laboratory examination showed that the hemoglobin level and red blood cell count did not continue to decline.No procedure- related complications occurred during and after the treatment. Conclusion For the treatment of anastomotic bleeding occurring after stapled Roux- en- Y choledochojejunostomy, endovascular embolization is safe and effective.

关 键 词：胆总管空肠Roux-en-Y术 血管内治疗 吻合口出血 

分 类 号：R657.4[医药卫生—外科学]