Endoscopic and radiosurgical diagnostics and treatment of biliodigestive bleeding

Aim of research is to find out the most suitable techniques for topical diagnosis of hemobilia, wirsungorrhea and, in general, biliodigestive bleeding with a broad introduction of endoscopic techniques in order to optimize treatment and reduce postoperative mortality. Materials and methods. Opportunities for topical diagnostics of biliodigestive hemorrhages of the hepatopancreatobiliary area by single and double-balloon endoscopy (DBE), video capsule endoscopy (VCE), spiral computed tomography (SCT), were found to be not prospective. Use of angiographic techniques and minimally invasive endovascular techniques in the diagnosing and stopping of bleeding becomes a method of choice. Results. In 11 patients with biliodigestive bleeding, the source was topically diagnosed and thrombosis of false aneurysm and its arterial branches with persistent haemostatic effect was achieved upon endogenous-venous occlusion. One patient died because of the outbreak of multiple organ failure upon liver abscess. Conclusion. X-ray surgical diagnostics and treatment of postoperative recurrent bleeding from arteries of the hepatopancreatoduodenal area by selective angiography, followed by percutaneous embolization of the revealed source of bleeding, confirms high effectiveness of the technique. A reliable hemostasis was achieved in 11 patients with one fatal outcome due to sepsis in a patient with extensive liver abscess.