{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:07:11Z","timestamp":1784369231894,"version":"3.55.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate percutaneous intrabiliary injection of gelatin sponge (Gelfoam) slurry as a preliminary salvage technique for acute hemobilia during biliary interventions when angiographic embolization is unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed eight patients with significant hemobilia during percutaneous biliary procedures between September 2024 and December 2025. Notably, seven patients (87.5%) had pre-existing clinical cholangitis that was controlled with therapeutic antibiotics prior to the bleeding event. Gelfoam slurry was injected directly into the biliary tree or tract to achieve hemostasis via internal compression and the promotion of localized thrombosis, while maintaining post-procedural catheter drainage and continued antibiotic coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Immediate technical hemostasis was achieved in all cases (100%). One instance of recurrent bleeding at 10\u00a0days was successfully managed with a repeat injection. Post-procedural infectious episodes (fever, leukocytosis) were observed in two patients (25%), requiring an upgrade in targeted antibiotic therapy. The pre-existing infectious baseline in the majority of the cohort complicates the distinction between recurrent cholangitis and de novo foreign-body-related infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preliminary experience suggests that intrabiliary Gelfoam slurry may represent a potential bridging or salvage maneuver for acute hemobilia in resource-constrained scenarios. However, because it relies on internal compression rather than definitive vascular repair, and carries potential risks of infectious exacerbation, it should be applied cautiously with strict follow-up and does not replace definitive transcatheter arterial embolization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42155-026-00697-5","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:02:04Z","timestamp":1784368924000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous intrabiliary injection of gelatin sponge slurry for the management of acute hemobilia during biliary interventions: an alternative salvage technique"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1897-0707","authenticated-orcid":false,"given":"Trieu Hai","family":"Pham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7483-0129","authenticated-orcid":false,"given":"Nhat Minh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4135-7458","authenticated-orcid":false,"given":"Linh Chi","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5344-4596","authenticated-orcid":false,"given":"Trung Quoc","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quyet Ta","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"697_CR1","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1148\/rg.2017160159","volume":"37","author":"N Venkatanarasimha","year":"2017","unstructured":"Venkatanarasimha N, Damodharan K, Gogna A, et al. Diagnosis and management of complications from percutaneous biliary tract interventions. Radiographics. 2017;37:665\u201380. https:\/\/doi.org\/10.1148\/rg.2017160159.","journal-title":"Radiographics"},{"key":"697_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/s42155-024-00442-w","volume":"7","author":"AO Oseni","year":"2024","unstructured":"Oseni AO, Chun J-Y, Morgan R, et al. Dealing with complications in interventional radiology. CVIR Endovasc. 2024;7:32. https:\/\/doi.org\/10.1186\/s42155-024-00442-w.","journal-title":"CVIR Endovasc"},{"key":"697_CR3","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/s00383-013-3291-y","volume":"29","author":"M Kumar","year":"2013","unstructured":"Kumar M, Goel P, Rawat JD, et al. Percutaneous trans\u2010hepatic Gelfoam\u2010cyanoacrylate glue embolization for ruptured post\u2010traumatic hepatic artery pseudo\u2010aneurysm in a limited\u2010resource scenario. Pediatr Surg Int. 2013;29:465\u20139. https:\/\/doi.org\/10.1007\/s00383-013-3291-y.","journal-title":"Pediatr Surg Int"},{"key":"697_CR4","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1007\/s11604-014-0292-2","volume":"32","author":"S Miyayama","year":"2014","unstructured":"Miyayama S, Yamakado K, Anai H, et al. Guidelines on the use of gelatin sponge particles in embolotherapy. Jpn J Radiol. 2014;32:242\u201350. https:\/\/doi.org\/10.1007\/s11604-014-0292-2.","journal-title":"Jpn J Radiol"},{"key":"697_CR5","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1007\/s00270-017-1703-4","volume":"40","author":"DK Filippiadis","year":"2017","unstructured":"Filippiadis DK, Binkert C, Pellerin O, et al. Cirse quality assurance document and standards for classification of complications: the Cirse classification system. Cardiovasc Intervent Radiol. 2017;40:1141\u20136. https:\/\/doi.org\/10.1007\/s00270-017-1703-4.","journal-title":"Cardiovasc Intervent Radiol"},{"key":"697_CR6","doi-asserted-by":"publisher","DOI":"10.14309\/crj.0000000000000254","volume":"6","author":"XJ Wang","year":"2019","unstructured":"Wang XJ, Buttar N, Storm AC. Management of hemodynamic collapse after liver transplantation from native bile duct stump hemorrhage with Gelfoam. ACG Case Rep J. 2019;6:e00254. https:\/\/doi.org\/10.14309\/crj.0000000000000254.","journal-title":"ACG Case Rep J"},{"key":"697_CR7","doi-asserted-by":"publisher","first-page":"S89","DOI":"10.1007\/s00586-004-0727-z","volume":"13","author":"C Schonauer","year":"2004","unstructured":"Schonauer C, Tessitore E, Barbagallo G, et al. The use of local agents: bone wax, gelatin, collagen, oxidized cellulose. Eur Spine J. 2004;13:S89-96. https:\/\/doi.org\/10.1007\/s00586-004-0727-z.","journal-title":"Eur Spine J"},{"key":"697_CR8","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004981.pub4","volume":"2013","author":"PV Tisi","year":"2013","unstructured":"Tisi PV, Callam MJ. Treatment for femoral pseudoaneurysms. Cochrane Database Syst Rev. 2013;2013:CD004981. https:\/\/doi.org\/10.1002\/14651858.CD004981.pub4.","journal-title":"Cochrane Database Syst Rev"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-026-00697-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-026-00697-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-026-00697-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:02:05Z","timestamp":1784368925000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42155-026-00697-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["697"],"URL":"https:\/\/doi.org\/10.1186\/s42155-026-00697-5","relation":{},"ISSN":["2520-8934"],"issn-type":[{"value":"2520-8934","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]},"assertion":[{"value":"23 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"For this type of study, formal ethical approval was not required. Informed consent was obtained from all individual participants included in the study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Consent for publication was obtained for every individual person\u2019s data included in the study","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"89"}}