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Biliary Tract Hemorrhage

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Xiaoping Yang – One of the best experts on this subject based on the ideXlab platform.

  • precise orientation and hepatectomy in the management of Biliary Tract Hemorrhage
    National Medical Journal of China, 2009
    Co-Authors: Jianguo Bo, Xiaoping Yang


    Objective To determine the method for locating the hemorrhagic site of Biliary Tract and assess the value of hepatectomy.Methods Clinical data of 23 patients with Biliary Tract Hemorrhage undergoing liver segmentectomy between January 1998 and October 2008 were analyzed. There were infection of biliar Tract or hepatolithiasis in 14 patients(60.9%), trauma in 6 (26.1%) and primary liver cancer in 3 (10.0%). Precise orientation was achieved by selective angiography in 5 patients and by bile duct exploration in 18. Operative approaches included left hemi-hepatectomy in 6 patients, left lateral lobectomy in 8, right hemi-hepatectomy in 4 and combined right segmentectomy in 5.Results All cases were successfully treated without any operative mortality. A majority of complications were bile leakage in 2 cases, subphrenic infection in 1, stress gastric ulcer in 1 and acute renal failure in 1. During the follow-up period of 8 months – 10 years in 15 patients, 3 died of recurrent or metastasis liver cancer and 2 Biliary cirrhosis.Conclusion Hepatectomy is advocated for the management of Biliary Tract Hemorrhage if bleeding is localized to a definite segment and the patient can tolerate the procedure.

    Key words:
    Biliary Tract Hemorrhage;  Hepatectomy

Kendou Kiyosawa – One of the best experts on this subject based on the ideXlab platform.

  • A case of transcatheter arterial embolisation effective for Biliary Tract Hemorrhage with retroperitoneal perforation caused by endoscopic procedures
    Gastroenterological Endoscopy, 2005
    Co-Authors: Hisanobu Saegusa, Yasuhide Ochi, Taiji Akamatsu, Hideaki Hamano, Mari Takayama, Kenichi Komatsu, Kendou Kiyosawa


    A 66-years-old woman underwent endoscopic sphincterotomy because of a common bile duct (CBD) stone. An eight-wire dormia basket catheter was used in order to remove the CBD stone, but the stone and the basket catheter were impacted in the intrapancreatic CBD. Despite the use of an endotoriptor, the wire of impacted basket was broken and the stone removal was not achieved. After endoscopic procedure, hematochezia and shock due to gastrointestinal bleeding occurred. Conservative treatment such as blood transfusion or administration of the catecholamines was not effective to control gastrointestinal bleeding. Therefore, she was transferred to our hospital for the purpose of intensive care. Because abdominal CT revealed retroperitoneal perforation, she did not have endoscopic technique for hemostasis but had transcatheter arterial embolisation (TAE). The second TAE achieved complete hemostasis and she recovered from shock. The impacted CBD stone and the basket catheter were migrated into the small intestine spontaneously while she had been waiting for surgical operation. She was discharged from our hospital after laparoscopic cholecystectomy. TAE is one of effective therapeutic maneuvers for post EST Hemorrhage in case that endoscopic treatment is avoided for some reason or is not effective. It will be worth planning prior to surgical intervention for patients with post EST Hemorrhage.

Brandt Lj – One of the best experts on this subject based on the ideXlab platform.

  • Bleeding causing Biliary obstruction after endoscopic sphincterotomy.
    The American Journal of Gastroenterology, 1997
    Co-Authors: Mosenkis Bn, Brandt Lj


    AbsTract A 68-yr-old woman who had had a cholecystectomy and endoscopic sphincterotomy developed recurrent common bile duct obstruction. She had another ERCP with extension of the site of endoscopic sphincterotomy, and 3 days later Biliary obstruction again developed, this time from a blood clot filling the common bile duct. The clot was removed by Fogarty technique, and the duct was irrigated with heparin; the obstruction resolved. Minor hemobilia (Biliary Tract Hemorrhage without overt GI bleeding) may be confused with choledocholithiasis. When Biliary obstruction follows endoscopic sphincterotomy, attempts at flushing the duct should precede empiric maneuvers for stone removal.