探讨经导管动脉栓塞（TAE）治疗胆胰十二指肠区术后出血的临床应用效果。

回顾性分析2018年7月至2024年7月间中国医学科学院北京协和医院97例因怀疑胆胰十二指肠区术后出血行数字减影血管造影（DSA）检查患者的临床资料，分析TAE治疗效果并比较经TAE治疗和未经TAE治疗患者的临床转归。再将经TAE治疗患者分为早期出血组和迟发性出血组，对比两组的TAE治疗效果是否有差异。

97例患者中，DSA检查提示出血患者57例（58.8%），所示出血动脉分别为胃十二指肠动脉16例，肝总动脉及分支8例，肠系膜上动脉及分支16例，胰十二指肠动脉及分支7例，胰大动脉1例，胰背动脉2例，脾动脉6例，胃左动脉1例。DSA阳性征象表现为单纯对比剂外溢39例（68.4%），单纯假性动脉瘤16例（28.1%），假性动脉瘤伴对比剂外溢2例（3.5%）。59例患者进行了TAE治疗，技术成功率为94.9%（56/59），临床成功率为86.4%（51/59），再出血率为8.5%（5/59）。59例TAE治疗患者中，早期出血组14例，技术成功率为92.9%（13/14），临床成功率为78.6%（11/14）；迟发性出血组45例，技术成功率为95.6%（43/45），临床成功率为88.9%（40/45）；两组技术成功率（P=0.564）和临床成功率（P=0.379）差异不具有统计学意义（P>0.05）。38例患者未经TAE治疗，再出血率为39.5%（15/38），死亡率为10.5%（4/38）。

TAE对胆胰十二指肠区术后出血的治疗具有明确疗效。不论是早期出血还是迟发性出血，TAE治疗都具有较高的应用价值。未进行TAE治疗的患者，仍有较高的再出血风险，但经积极处理，死亡率并无明显增加。

To investigate the efficacy of transcatheter arterial embolization (TAE) in treating postoperative hemorrhage in the gallbladder-pancreas-duodenum(GPD) region.

The clinical data of 97 patients diagnosed with postoperative hemorrhage in the GPD region and underwent digital subtraction angiography(DSA) examination in Peking Union Medical College Hospital from July 2018 to July 2024 were retrospectively analyzed. The effect of TAE treatment were analyzed, and the clinical regression of TAE-treated and non-TAE-treated patients were compared. The TAE-treated patients were then divided into the early hemorrhage group and the late hemorrhage group, and whether there was a difference in the TAE treatment effect between the two groups was compared.

Among 97 patients, DSA examination suggested active bleeding in 57 patients (58.8%), including gastroduodenal artery hemorrhage in 16 cases, common hepatic artery and branches hemorrhage in 8 cases, superior mesenteric artery and branches hemorrhage in 16 cases, pancreaticoduodenal artery and branches hemorrhage in 7 cases, pancreatic aorta hemorrhage in 1 case, dorsal pancreatic artery hemorrhage in 2 cases, splenic artery hemorrhage in 6 cases, and left gastric artery hemorrhage in 1 case. Positive DSA signs manifested as contrast leakage alone in 39 cases (68.4%), pseudoaneurysm alone in 16 cases (28.1%), and pseudoaneurysm with contrast spillage in 2 cases (3.5%). Technical success, clinical success, and rebleeding rates in patients underwent TAE were 94.9% (56/59), 86.4% (51/59), and 8.5% (5/59) respectively. Among the 59 patients treated with TAE, 14 cases were in the early hemorrhage group, with a technical success rate of 92.9% (13/14) and a clinical success rate of 78.6% (11/14); 45 cases were in the late hemorrhage group, with a technical success rate of 95.6% (43/45), and a clinical success rate of 88.9% (40/45). There were no statistically significant differences between the two groups in terms of technical success rate (P=0.564) and clinical success rate (P=0.379) (P>0.05).The rebleeding rate in patients did not underwent TAE was 39.5%(15/38), the mortality was 10.5% (4/38).

TAE has a clear therapeutic effect on postoperative hemorrhage in the GPD region. TAE treatment has high application value for both early and late hemorrhage. Patients without TAE treatment still had a high risk of rehemorrhage, but with aggressive management, there was no significant increase in mortality.