ĐÁNH GIÁ HIỆU QUẢ CỦA PHƯƠNG PHÁP CAN THIỆP NỘI MẠCH TRONG ĐIỀU TRỊ CHẢY MÁU TÁ TRÀNG

Abstract

Purpose: To evaluate the efficacy and safety of endovascular embolization in treatment of acute duodenal bleeding. Materials and method: Retrospective and prospective descriptive study, from January 2020 to June 2021, 21 cases diagnosed as duodenal bleeding, were alternatively attempted to the transcatheter arterial embolization (TAE) under the guidance of DSA (digital subtraction angiography). Results: The technical and clinical success rates of TAE were respectively 21/21 (100%) and 14/21 (66,7%). The early complication of recurrent bleeding rate for 4/21 (19%), of which 1 patient was embolized for the second time, the last 3 cases were repeated endoscopic or hemostasis surgery secondary. There was 1 case with duodenal ischemic complication checked by repeated endoscopic post – embolotherapy due to duodenal tumor, followed by surgical intervention. Mortality rate within 30 days after embolization was 9/21 (42.8%), 2 patients had poor prognosis due to tumor progression without rebleeding, the remaining patients was affected by underlying diseases, coagulation disorders, death leaded by hemorrhagic shock or multiple organ failure. Conclusion: The hemostatic embolization therapy in the treatment of duodenal bleeding has been shown to be a safe and effective method in the management and control of duodenal hemorrhage refractory to endoscopic treatment, especially for elderly patients with severe comorbidities and high risks.