摘要目的观察血管造影和肝动脉栓塞术对胆道术后胆道出血的诊断和治疗价值。方法 9例在胆道手术后7天到3个月出现上消化道出血。所有患者行急诊肝动脉造影并采用明胶海绵和微钢圈进行肝动脉栓塞治疗。结果肝动脉造影检查可见肝动脉假性动脉瘤3例；肝动脉弥漫性出血3例；右肝动脉胆道瘘2例和肝动脉小肠瘘1例。通过肝动脉栓塞控制胆道出血7例，其中1例再出血。7例患者随访其中3例死于多功能脏器衰竭。2例因技术原因无法止血，数天后死亡。结论胆道手术后出现上消化道出血如怀疑是胆道出血，应首先采用肝动脉血管造影检查，同时尽可能早地采用选择性肝动脉栓塞术治疗胆道出血，可获得较好的临床效果。

abstractsObjective　To evaluate the effectiveness of hepatic angiography and embolization in the diagnosis and treatment of hemobilia after hepatobiliary surgery.Methods　Nine patients had upper gastrointestinal bleeding 7 days to 3 months after surgery. They underwent emergency hepatic artery angiography and were treated by embolization using Gelfoam particles only (8 patients) and Gelfoam particles plus microcoils (1 patient). Results　Hepatic artery angiography revealed hepatic artery pseudoaneurysms in 3 patients, diffuse hemorrhage of the hepatic artery branches in 3, right hepatic artery-bile duct fistulas in 2, and hepatic artery-small intestine fistula in 1. Hemobilia was controlled with embolization in 7 patients, of whom 1 had recurrent bleeding 1 day after treatment. During the follow-up, 3 patients died of multiple organ dysfunction syndrome. Two patients whose hemorrhage could not be controlled due to technical reasons died several days later. Conclusion　When hemobilia after hepatobiliary surgery is suspected, patients should receive hepatic angiography as a first diagnostic procedure and be treated with minimally invasive procedure of selective embolization of the involved artery as soon as possible.