Hemobilia due to hepatocellular carcinoma： cholangioscopicfindings and novel endoscopic hemostasis

作     者：takeshi ogura atsushi okuda kazuhide higuchi 

作者机构：second department of internal medicineosaka medical college2-7 DaigakuchouTakatsukishiOsaka 569-8686Japan 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2018年第17卷第3期

页      面：275-277页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：COVERED METALLIC STENT 

摘      要：To the Editor： Trauma, inflammation, iatrogenic procedures such as liverbiopsy and percutaneous transhepatic biliary drainage （PTBD）, vascularanomalies, coagulopathy status, and malignancy can cause hemobilia [1]. Malignant causes of hemobilia include cholangiocarcinoma,pancreatic cancer, gallbladder tumor, and liver metastasis,but rarely hepatocellular carcinoma （HCC）. Here, we describeachieving endoscopic hemostasis for hemobilia caused by HCC,which was visualized using the single-operator, SPY-DS cholangioscope（Boston Scientific, Tokyo, Japan） under endoscopic retrogradecholangiopancreatography （ERCP） guidance. This scope is a dramaticimprovement over the SpyGlass system in that it is easier to insert into the biliary tract due to a tapered tip, a 120° digitalfield-of-view provides favorable visualization, and new injection and suction functions have been added via a two-port adaptor.