ĐÁNH GIÁ HIỆU QUẢ ĐIỀU TRỊ VÀ MỘT SỐ YẾU TỐ LIÊN QUAN CỦA CAN THIỆP NỘI MẠCH TRONG ĐIỀU TRỊ XUẤT HUYẾT SAU PHẪU THUẬT TIÊU HÓA

Abstract

Objective: To assess the effectiveness, safety, and some related factors of endovascular embolization in the treatment of postoperative bleeding in gastrointestinal surgery at Viet Duc Hospital. Subjects and Methods: Cross-sectional descriptive study with retrospective and prospective data collection, conducted from September 2019 to June 2025. Twenty-eight patients diagnosed with intra-abdominal bleeding or gastrointestinal hemorrhage (GIH) after gastrointestinal-hepato-pancreatic surgery who underwent embolization at Viet Duc Hospital were included. Results: Among the 28 patients, there were 18 males and 10 females, with an average age of 65.82 years (ranging from 33 to 92). Surgical history included bowel resection (28.6%), pancreaticoduodenectomy (28.6%), hepatobiliary surgery (21.4%), gastric–duodenal perforation repair (14.3%), and gastrointestinal fistula surgery (7.1%). Technical success was achieved in 100% (28/28), and clinical success was 82.8% (23/28). Factors potentially associated with clinical failure included having two or more comorbidities, significant hemoglobin decrease (>30 g/L), and age over 70, though these differences were not statistically significant. No complications directly related to the intervention were observed. The 30-day mortality rate post-embolization was 17.85% (5/28); among these, three died due to recurrent bleeding combined with other factors such as pneumonia, cachexia, and chronic diseases; two died from severe infections and multiorgan failure unrelated to recurrent bleeding. Conclusion: Endovascular embolization is a safe and effective method for managing postoperative gastrointestinal bleeding, especially in patients with both intra-abdominal and gastrointestinal hemorrhage who fail endoscopic treatment.