Interventional radiology, as an emerging discipline that integrates diagnostic imaging and clinical treatment, has become increasingly integrated into various clinical fields with the continuous progress of related medical equipment, materials and technology, and has become an important method for the diagnosis and treatment of many diseases. Among them, interventional radiology has been widely and deeply applied in abdominal surgery, which has improved the treatment process and treatment level in abdominal surgery in many aspects, and has become an important part of the diagnosis and treatment of abdominal surgery. According to the current development status and prospect, the application of interventional radiology in abdominal surgery is outlined as follows. A, the diagnosis and treatment of bleeding diseases 1, gastrointestinal arterial bleeding: gastrointestinal arterial bleeding is one of the common symptoms of gastrointestinal diseases, for the conservative treatment of persistent bleeding or acute hemorrhage, patients in the past, only one choice of surgery. Nowadays, selective angiography of the abdominal artery can be performed regardless of the patient’s status and with the support of life-support systems and measures to identify the cause and site of bleeding. If the bleeding volume is > 0.5 ml/min, angiography can usually detect signs of contrast spillage. If there is no contraindication, embolization is feasible to stop the bleeding after the bleeding site is detected by angiography. 2.Substantial organ hemorrhage: After the cause and site of hemorrhage are clearly identified by hepatic and splenic artery angiography, embolization treatment can often achieve good hemostatic effect, and the damage to patients is smaller than that of surgery, which is easier for patients to accept. For those patients who bleed again after surgical operation, interventional embolization is often the only choice to stop bleeding. Diagnosis and treatment of tumor 1. Percutaneous biopsy: All occupying lesions of organs without pathological diagnosis, especially lesions in areas that are difficult to reach through internal pipeline system, can be diagnosed pathologically by percutaneous biopsy. Of course, the current imaging equipment and laboratory tests can provide a qualitative diagnosis for most of the substantial abdominal occupying lesions, but there are still misdiagnoses and many cases that cannot be diagnosed definitively. Percutaneous biopsy, on the other hand, can provide a definitive pathologic diagnosis. For those lesions that are clinically diagnosed as malignant occlusive lesions, biopsy can be performed to clarify their histocytological type, which is valuable for guiding the next step of surgery or radiotherapy or chemotherapy. 2.Angiography: Angiography can further clarify the diagnosis of tumor lesions and understand the extent of lesions and blood supply. For example, in the case of atypical hepatic cavernous hemangioma, hepatic arteriogram has important diagnostic value when other diagnostic imaging opinions are not uniform or lack of characteristic features to differentiate it from hepatocellular carcinoma. In addition, angiography can sometimes detect small tumor foci that cannot be detected on CT or MRI. In the advanced stages of the disease, the main trunk of the portal vein and its left and right intrahepatic branches can be visualized in the abdominal trunk artery or superior mesenteric artery angiography, which is known as indirect portal vein angiography. In addition, direct portal venography can be performed by percutaneous hepatic puncture or percutaneous splenic puncture to understand the condition of portal vein or to perform interventional treatment. 3.chemoembolization: chemotherapeutic drug infusion and/or embolization of tumor vessels is the main and fundamental method of interventional treatment for tumor diseases, and it is also the first choice for the treatment of some middle and late stage tumors, especially for the treatment of middle and late stage liver cancer. 4.Percutaneous percutaneous tumor ablation: there are mainly two types of physical ablation and chemical ablation. This method is usually applied to the primary foci or metastases in the liver with small size, clear boundary and small number; or some lesions that are not satisfactorily ablated after transarterial chemoembolization. Physical ablation mainly includes radiofrequency ablation and microwave ablation treatment. Chemical ablation is also performed by percutaneous puncture under ultrasound or CT guidance. A 21 or 22 G needle is inserted into the tumor at multiple points and angles and injected with anhydrous ethanol, acetic acid or certain cell cycle non-specific chemotherapeutic drug solutions to ablate the tumor cells. In addition, hot saline can also be injected to ablate the tumor. Interventional treatment of portal hypertension 1. Post-hepatitis cirrhosis: More than 90% of portal hypertension in China is due to narrowing or occlusion of liver sinusoids caused by hepatitis cirrhosis. Currently, liver transplantation is an effective surgical treatment for end-stage liver disease, but for those who are unable or unwilling to undergo liver transplantation, treatment for the complications of portal hypertension is still needed. Treatment of ruptured esophagogastric fundic varices: ① Transjugular route intrahepatic portosystemic intravenous stent shunt (TIPSS): For patients with acute hemorrhage or history of hemorrhage, emergency TIPSS can be considered, in which a channel is established between the intrahepatic hepatic vein and the main branches of the portal vein via the jugular vein, and a stent is placed to form a portal shunt. TIPSS and DIPS are similar in principle to surgical portico-inferior vena cava lateral anastomosis, except that they are easier and safer to perform than the latter. Gastric coronary vein embolization: Gastric coronary vein embolization is the selective embolization of the varicose coronary vein after percutaneous hepatic portal venography. This method is used as an emergency measure to stop bleeding when medical measures are ineffective for ruptured varices in the fundic esophagus. Alternatively, it can be used as a prophylactic measure to divert blood flow to other collateral circuits. This technique is usually performed in conjunction with splenic embolization, which significantly reduces the volume of blood in the portal vein and is more conducive to reducing the pressure in the portal vein. 3.Treatment of hypersplenism: Partial splenic artery embolization is an effective alternative to surgical splenectomy because of the partial inactivation of the spleen by embolizing some of the splenic artery branches, thus effectively improving the peripheral blood picture of the patient while preserving the immune function of the spleen; it is also simple, less painful for the patient, faster recovery, and fewer postoperative complications. Partial splenic artery embolization is not only effective in treating hypersplenism in cirrhosis, but can also reduce the pressure in the portal vein for a period of time, which is also beneficial in portal hypertension. Similarly, partial splenic artery embolization is effective in certain hematologic diseases such as thalassemia, hereditary spherocytosis, and idiopathic thrombocytopenic purpura. 4, intractable ascites: the most effective method of cirrhosis intractable ascites is liver transplantation. However, TIPSS is also an option that can be considered, but with good indications. Budd-Chiari syndrome: Interventional treatment of Budd-Chiari syndrome uses balloon dilation of the stenotic segment of the inferior vena cava or perforation of the septum, then balloon dilation and shaping, and placement of internal stents into the inferior vena cava. If the hepatic vein is occluded and the paracavalvular vein is not sufficiently compensated, reconstruction of the second hepatic hilar is also required by puncturing and dilation of the hepatic vein and placing an internal stent to reconstruct the second hepatic hilar. Interventional treatment of Budd-Chiari syndrome has become the preferred method for this disease because of its efficacy, safety and minimally invasive features. Treatment of obstructive jaundice Percutaneous hepatic percutaneous biliary drainage and/or percutaneous hepatic percutaneous endobiliary stent placement is the treatment of choice for obstructive jaundice. Nowadays, the left or right intrahepatic dilated bile duct is usually punctured under the guidance of B ultrasound, and then a guidewire catheter is introduced through the coaxial exchange technique, and internal or external biliary drainage is performed according to the specific situation. For malignant tumor-induced obstructive jaundice and inoperable or unwilling to operate, biliary stents or radiation or chemotherapy can be placed, and long-term placement of catheters for palliative treatment is also available. V. Interventional treatment of abdominal cystic lesions 1. liver cysts, spleen cysts: for true cysts with compression symptoms, risk of rupture and bleeding, co-infection, or large diameter (usually > 5 cm), the cysts can be punctured under the guidance of B ultrasound or CT, and sclerotherapy can be performed with anhydrous ethanol after aspiration of the cyst fluid. 2. Pancreatic cysts and pancreatic pseudocysts: the cysts can be punctured under B-ultrasound or CT guidance, aspirated and then drained with a tube, and then removed after the cysts are occluded. In some cases, surgical radical treatment is required. 3, liver, spleen abscess, abdominal abscess: the abscess can be punctured under the guidance of B ultrasound or CT, the pus can be extracted and then placed in the tube for drainage, and the more limited abscess can be flushed with antibiotic saline to speed up the healing. The pancreatitis intervention 1, pancreatitis infusion chemotherapy: the catheter is inserted into the blood supply artery of the pancreas through the femoral artery, and the tube is placed to infuse 5-Fu and / or ginseng and other drugs. It is used to treat pancreatitis by inhibiting pancreatic secretion, pancreatic enzyme activity and improving pancreatic circulation. Treatment of severe pancreatitis combined with bleeding: In severe pancreatitis, pancreatic fluid overflows into the abdominal cavity, and a large number of pancreatic enzymes are activated, which corrode and invade the abdominal vessels and cause bleeding. In this case, it is impossible to stop the bleeding through surgery. However, through interventional angiography, the site and cause of bleeding can be clarified, and embolization treatment can be performed as appropriate to stop the bleeding, which can often save the patient’s life. Now it has become an indispensable part of the comprehensive treatment of severe pancreatitis. Other applications 1. Visceral nerve and abdominal plexus block: It is used for chronic, persistent and intractable pain caused by abdominal organ lesions innervated by the abdominal plexus, commonly used in pancreatic cancer, gastric cancer and liver cancer. Under the guidance of CT, a 22G needle is used to puncture around the abdominal plexus and anhydrous ethanol is used to destroy the plexus, thus blocking the nerve conduction pathway and providing pain relief. 2, abdominal aortic aneurysm, abdominal aortic coarctation aneurysm: abdominal aortic aneurysm, abdominal aortic coarctation aneurysm can be treated by interventional methods to abdominal aortic aneurysm artificial endovascular stent luminal isolation and abdominal aortic coarctation percutaneous artificial vascular stent luminal isolation. However, the specific conditions of the lesion and the extent of involvement must be clearly understood before the operation, and the cases suitable for interventional treatment should be selected. 3.Dilation and angioplasty of gastrointestinal stenosis: It is suitable for scarred esophageal stenosis, advanced esophageal cancer or recurrence after radiotherapy, anastomotic stenosis after gastrointestinal surgery, pyloric obstruction and cardia incontinence. Depending on the specific situation, balloon dilation and shaping can be performed, and in some patients, especially in the treatment of some malignant diseases, stents can be placed palliatively. In summary, interventional radiology is an emerging discipline that integrates diagnosis and treatment, and its application in abdominal surgery is widespread and in-depth. With the further deepening of horizontal communication and penetration among clinical disciplines, we believe that interventional radiology will continue to have surprising new developments.