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Non-operative management of haemobilia
1Department of General Surgery, University of Natal, Durban, South Africa. moodleyj6@nu.ac.za
Background:
The aim was to evaluate a non-operative approach to the management of haemobilia.
Methods:
This was a retrospective analysis of patients presenting over 10 years with haemobilia. All patients had upper gastrointestinal endoscopy, abdominal ultrasonography and digital subtraction angiography. Superselective coil and/or Gelfoam embolization was done as close as possible to the bleeding site. Completion angiography was performed routinely to confirm adequate embolization.
Results:
There were 23 patients with liver trauma and six with inflammatory conditions. All patients required resuscitation with fluids and blood transfusion, and had the haemobilia controlled successfully by angiographic embolization. There was one death from fulminant hepatic sepsis.
Conclusion:
This series attests to the efficacy of a non-operative approach to haemobilia using radiological diagnosis and intervention.