Management of Bleeding from the Bile Duct



Bleeding from the gallbladder or biliary tree (“hemobilia”) is not seen frequently in clinical practice. Historically, hemobilia was predominantly observed in the trauma setting. Both penetrating and blunt trauma have been recognized as a common source of hemobilia since the review by Sandblom [1]. Currently, trauma is believed to represent only 1–3% of cases of hemobilia [2, 3]. In recent years, there has been a dramatic increase in both diagnostic and therapeutic hepatobiliary procedures. This has resulted in a dramatic increase in the incidence of iatrogenic hemobilia [4] which is becoming important in clinical practice. The etiology of iatrogenic hemobilia is diverse. It may be observed, for example, after endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiograms, percutaneous biliary drainage, preoperative portal vein embolization, radiofrequency ablation, and liver biopsies.


Transjugular Intrahepatic Portosystemic Shunt Biliary Tree Underlying Liver Disease Acalculous Cholecystitis Hepatic Trauma 
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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Transplant Surgery and Hepatobiliary Surgery, Department of SurgeryDuke University of RochesterRochesterUSA
  2. 2.Department of AnesthesiaUniversity of RochesterRochesterUSA

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