摘要
We report a case of a 74-year-old woman with a 16-year history of a double bilo-enteric anastomosis due to resected hilar cholangiocarcinoma [Type IIIb Klatskin tumor]. The patient presented with cholangitis secondary to benign anastomotic stenosis which resulted in a large intrahepatic biloma. In order to restore the patency of the anastomosis and overcome cholangitis, several attempts took place, including endobiliary stenting, balloon-assisted biloplasty and transhepatic billiary drainage. Anastomotic patency was achieved, complicated, however, by persistent upper gastro-intestinal bleeding, presented as hemobilia. A biloma-induced pseudoaneurysm of the left hepatic artery was diagnosed. This had ruptured into the biliary tract, and presented the actual cause of the hemobilia. Selective embolism of the pseudoaneurysm resulted in control of the hemorrhage, and was successfully combined with transhepatic dilatation of the anastomosis and percutaneous drainage of the biloma. The patient was ultimately cured and seems to be in excellent condition, 5 mo after treatment.
我们由于 resected 门 cholangiocarcinoma (类型 IIIb Klatskin 肿瘤) 与双 bilo 伤寒吻合的 16 年的历史报导一个 74 岁的女人的一个案例。与对导致了大肝内 biloma 的良性的吻合狭窄第二等的胆管炎介绍的病人。以便恢复吻合的明显并且克服胆管炎，几次尝试发生了，包括 endobiliary 小型机关枪的一种叮当响，帮助汽球的 biloplasty 和 transhepatic billiary 排水。吻合明显被完成，复杂，然而由坚持上面的胃肠的流血，作为胆道出血介绍了。左肝的动脉的一个导致 biloma 的假动脉瘤被诊断。这破裂了进胆道，并且介绍了胆道出血的实际原因。假动脉瘤的选择栓塞控制出血结果，并且成功地与吻合的 transhepatic 膨胀和 biloma 的经皮的排水被相结合。病人最终被治好并且似乎处于优秀状况， 5 瞬间术后疗法。
