REPORT OF 4 USEFULE CASES OF THE INTER VENTIONAL RADIOLOGY FOR HEMORRAGE INDUCED BY NONSURGICAL TREATMENT FOR BILIARY DISEASES

Abstract

Endoscopic sphincterotomy (EST), percutaneous transhepatic cholangiodrainage (PTCD) and applied therapeutic endoscopy were recently popular procedures in Japan. Although complications are decreased by improvement of instrument and technique, they occur more frequent than that of another procedures and they sometimes result in severe ones due to association with vascular injury. We experienced 4 cases with bleeding who developed vascular jnjury, however we succeeded in hemostasis by interventional radiology (IVR) such as the transcatheter arterial embolisation (TAE) and complete hemostasis was obtained. Including a case with jaundice, all cases were well after TAE. After hemostasis, progress of all of cases including one case with jundice were well and we thought that it was possible to stop the bleeding by super-selective TAE for patients with low hepatic reserve. Wherever invasive procedures such as EST and PTCD are carried out, it is important to prevent the complications with possible case. But when vascular injury occurred, angiography and some IVR, such as TAE should be initially selected.