Endovascular treatment of delayed arterial hemorrhage following surgery for cholangiolithiasis

Abstract Objectives To retrospectively evaluate the safety and efficacy of endovascular treatment (EVT) of delayed arterial hemorrhage (DAH) following surgery for cholangiolithiasis. Methods All patients who underwent EVT to manage DAH after surgery for cholangiolithiasiswere enrolled in this study. Demographic, laboratory, angiographic, and clinical follow-up data were collected and analyzed. Results 15 patients were enrolled. The origins of bleeding were the right hepatic artery (RHA，n=6), the RHA branch (n=3), the gastroduodenal artery (GDA, n=2) and the GDA branch (n=4). Embolization and covered stents implantation were performed in 11 patients and 4 patients, respectively. The technical success rate was 100.0% (15/15) and the clinical success rate was 66.7% (10/15). For rebleeding patients, injured artery was identified and successfully occluded by a second angiography in 2. One patient had acute hepatic failure and recovered subsequently. The overall survival rate was 86.7% (13/15) during the follow-up of 90 days after EVT. Conclusion EVT of DAH after surgery for cholangiolithiasis is effective and safe. Angiography is also a valuable treatment alternative for rebleeding patients who have technical successfully been ceased the bleeding at the previous EVT.