[1]曾昭吝,蔡明岳,黄文薮,等.肝动脉化疗栓塞术后胆汁瘤形成63例临床分析[J].介入放射学杂志,2013,(12):989-993.
 ZENG Zhao? lin,CAI Ming? yue,HUANG Wen? sou,et al. The formation of intrahepatic biloma after transcatheter arterial chemoembolization: a clinical analysis of 63 cases[J].journal interventional radiology,2013,(12):989-993.
点击复制

肝动脉化疗栓塞术后胆汁瘤形成63例临床分析 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2013年12期
页码:
989-993
栏目:
肿瘤介入
出版日期:
2013-12-25

文章信息/Info

Title:
 The formation of intrahepatic biloma after transcatheter arterial chemoembolization: a clinical analysis of 63 cases
作者:
 曾昭吝 蔡明岳 黄文薮 郭永建 陈俊伟 王皓帆 朱康顺
Author(s):
 ZENG Zhao?蛳 lin CAI Ming?蛳 yue HUANG Wen?蛳 sou GUO Yong?蛳 jian CHEN Jun?蛳 wei WANG Hao?蛳 fan ZHU Kang?蛳 shun.
Department of Radiology, the Third Affiliated Hospital and Interventional Radiology Institute, Sun Yat?蛳 sen University, Guangzhou 510630, China
关键词:
 【关键词】 肝肿瘤 肝动脉化疗栓塞术 胆汁瘤 并发症
文献标志码:
A
摘要:
 【摘要】 目的 探讨经导管肝动脉化疗栓塞术(TACE)或肝动脉栓塞术(TAE)后胆汁瘤形成的临床表现、治疗方法及预后。方法 回顾性分析2005年1月—2013年3月行TACE/TAE后形成胆汁瘤的63例患者的临床及影像学资料,分析有无临床症状、胆汁瘤的治疗方式及临床转归。结果 63例患者中,52例胆汁瘤发生于TACE术后4周 ~ 3个月,占82.5%,11例胆汁瘤发生于TACE/TAE术后3 ~ 6个月,占17.5%。63例胆汁瘤形成患者中48例(76.2%)无临床症状,其胆汁瘤直径(2.64 ± 2.20)cm;有症状胆汁瘤15例,胆汁瘤直径(6.98 ± 6.57)cm,有无症状者胆汁瘤大小比较差异有显著统计学意义(P < 0.01)。48例无症状胆汁瘤影像学随访时间37 d至49个月,其中30例(62.5%)大小无变化,13例(27.1%)缩小,3例(6.3%)消失,1例增大,1例胆汁瘤直径3.8 cm、临近肝包膜,发生破裂形成胆汁性腹膜炎,1周后死于感染性休克、肝功能衰竭。有症状胆汁瘤15例临床表现有黄疸2例,发热11例,黄疸并有发热2例。均行穿刺置管引流,11例(71.3%)缩小,4例消失;14例临床症状缓解后拔管,置管时间53 d ~ 11个月,1例合并缺血性胆道狭窄,持续引流18个月仍反复发热。结论 胆汁瘤作为TACE/TAE的并发症之一,多发生于术后4周 ~ 3个月。无症状者,应定期影像随访,对有症状或临近肝包膜较大的胆汁瘤,应及时穿刺置管引流。

参考文献/References:

 [1] 陈自谦, 杨 利, 杨熙章, 等. 肝癌介入治疗现状与进展[J]. 介入放射学杂志, 2008, 17: 223 ?蛳 227.
[2] Pelletier AL, Hammel P, Zappa M, et al. Fatal bile duct necrosis: a rare complication of transcatheter arterial chemoembolization in a patient with endocrine hepatic metastasis[J]. Case Rep Gastroenterol, 2008, 2: 356 ?蛳 362.
[3] Sakamoto I, Iwanaga S, Nagaoki K, et al. Intrahepatic biloma formation (bile duct necrosis) after transcatheter arterial chemoembolization[J]. Am J Roentgenol, 2003, 181: 79 ?蛳 87.
[4] Yu JS, Kim KW, Jeong MG, et al. Predisposing factors of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatic malignancy[J]. Cardiovasc Intervent Radiol, 2002, 25: 270 ?蛳 274.
[5] Bhagat N, Reyes DK, Lin M, et al. Phase II study of chemoembolization with drug ?蛳 eluting beads in patients with hepatic neuroendocrine metastases: high incidence of biliary injury[J]. Cardiovasc Intervent Radiol, 2013, 36: 449 ?蛳 459.
[6] 中国抗癌协会肝癌专业委员会. 原发性肝癌诊断标准[J]. 中华肝脏病杂志, 2000, 8: 135.
[7] Kim HK, Chung YH, Song BC, et al. Ischemic bile duct injury as a serious complication after transarterial chemoembolization in patients with hepatocellular carcinoma[J]. Clin Gastroenterol, 2001, 32: 423 ?蛳 427.
[8] 罗鹏飞, 符 力, 陈晓明. 肝癌介入治疗后胆汁瘤的形成与临床意义[J]. 中华放射学杂志, 2000, 34: 757.
[9] 蒲淼水, 李朝龙, 李 峰. 肝动脉栓塞化疗后肝内胆道并发症(附108例分析)[J]. 肝胆外科杂志, 1999, 7: 420 ?蛳 422.
[10] Miyayama S, Yamashiro M, Okuda M, et al. Main bile duct stricture occurring after transcatheter arterial chemoembolization for hepatocellular carcinoma[J]. Cardiovasc Intervent Radiol, 2010, 33: 1168 ?蛳 1179.
[11] Cho KJ, Lunderquist A. The peribiliary vascular plexus: the microvascular architecture of the bile duct in the rabbit and in clinical cases[J]. Radiology, 1983, 147: 357 ?蛳 364.
[12] 王 翔, 程红岩, 乐 园, 等. 经肝动脉途径行肝癌化疗栓塞后胆汁瘤形成的CT表现及临床意义[J]. 中华放射学杂志, 2006, 40: 241 ?蛳 244.
[13] 王茂强, 邵如宏, 叶慧义, 等. 肝动脉化疗栓塞术后胆管损伤的影像学研究[J]. 中华肿瘤杂志, 2005, 27: 609 ?蛳 612.
[14] 龚高全, 王小林, 王建华, 等. 乏血供肝脏肿瘤经肝动脉化疗栓塞后胆汁瘤形成[J]. 复旦学报: 医学版, 2008, 35: 597 ?蛳 608.
[15] Kim W, Clark TW, Baum RA, et al. Risk factors for liver abscess formation after hepatic chemoembolization[J]. Vasc Interv Radio, 2001, 12: 965 ?蛳 968.
[16] 周 陈, 丁文彬, 袁瑞凡, 等. 肝胆汁瘤的介入治疗[J]. 介入放射学杂志, 2011, 20: 882 ?蛳 884.

相似文献/References:

[1]张 琳,黄学全,王健,等.自主研发电化学治疗同轴电极与传统针式电极电解效应的对比研究[J].介入放射学杂志,2012,(02):148.
 ZHANG Lin,HUANG Xue-quan,WANG Jian,et al.The electrolytic effect in electrochemotherapy: a comparative study between self-prepared coaxial electrode and conventional needle electrode[J].journal interventional radiology,2012,(12):148.
[2]赵 玮,王伟中,陈莹,等.耳部动静脉畸形供血动脉的血管造影研究[J].介入放射学杂志,2012,(02):103.
 ZHAO Wei,WANG Wei-zhong,CHEN Ying,et al.Angiographic findings of the feeding arteries of auricular arteriovenous malformations[J].journal interventional radiology,2012,(12):103.
[3]邹俊民,龙世娟,张振明. 改良髂内动脉化疗联合放疗治疗Ⅲ~Ⅳa期 子宫颈癌32例[J].介入放射学杂志,2012,(02):123.
 ZOU Jun-min,LONG Shi-Juan,ZHANG Zheng-ming..Improved internal iliac artery chemotherapy combined with radiotherapy for the treatment of stage Ⅲ-Ⅳa cervical cancers[J].journal interventional radiology,2012,(12):123.
[4]王昌明,李 选,宋世兵,等.肝门部胆道引流管折叠技术在肝移植后胆道非吻合口狭窄治疗中的应用[J].介入放射学杂志,2012,(02):136.
 WANG Chang-ming,LI Xuan,SONG Shi-bing,et al.The application of biliary catheter folding technique in the treatment of hilar nonanastomotic biliary strictures after orthotopic liver transplantation[J].journal interventional radiology,2012,(12):136.
[5]赵玉峰,孙玉琴,韩晓静,等. 输卵管介入再通术后受孕时机的研究[J].介入放射学杂志,2012,(02):158.
 ZHAO Yu-feng,SUN Yu-qin,HAN Xiao-jing,et al.The optimal time for conception after fallopian tube recanalization therapy[J].journal interventional radiology,2012,(12):158.
[6]含 笑,曹建民,史东宏,等.吉西他滨、顺铂动静脉联合化疗治疗晚期非小细胞肺癌的近期疗效分析[J].介入放射学杂志,2012,(02):119.
 HAN Xiao,CAO Jian-min,SHI Dong-hong,et al.Bronchial artery infusion of Gemcitabine and Cisplatin combined with systemic chemotherapy for advanced non-small cell lung cancer: its short-term efficacy[J].journal interventional radiology,2012,(12):119.
[7]姚雪松,李 槐.不可手术切除的肝细胞癌的疗效评价标准——改良RECIST标准更可靠[J].介入放射学杂志,2012,(03):177.
 . Therapeutic evaluation criterion of inoperable hepatocellular carcinomas: modified RECIST as a more reliable standard[J].journal interventional radiology,2012,(12):177.
[8]齐 立,李慎茂,俸军林,等. 动脉溶栓与机械碎栓联合动脉溶栓的对比分析[J].介入放射学杂志,2012,(03):180.
 ,,et al. Comparison of the therapeutic efficacy between simple arterial thrombolysis and mechanical thrombectomy combined with arterial thrombolysis for acute cerebral infarction at its ultraearly stage[J].journal interventional radiology,2012,(12):180.
[9]石 潆,赵 卫,沈 进,等.脑动静脉畸形栓塞治疗术并发颅内出血的原因及处理[J].介入放射学杂志,2012,(03):185.
 ,,et al.Intracranial hemorrhage due to embolization therapy for cerebral arteriovenous malformation: its causes and management [J].journal interventional radiology,2012,(12):185.
[10]周 慷,李晓光,金征宇,等.清宫术前子宫动脉化疗栓塞术治疗瘢痕妊娠的疗效分析[J].介入放射学杂志,2012,(03):190.
 ,,et al.Therapeutic analysis of bilateral uterine artery chemoembolization performed before uterine dilation and curettage for cesarean scar pregnancy [J].journal interventional radiology,2012,(12):190.
[11]杜 鲲,管 生,胡小波,等. 原发性肝癌TACE术后完全缓解病灶磁共振 ADC值可重复性及一致性研究[J].介入放射学杂志,2011,(11):867.
 DU Kun,GUAN Sheng,HU Xiao-bo,et al.Magnetic resonance apparent diffusion coefficient values of the completely remitted lesions of primary hepatocellular carcinoma after TACE: a study of their repeatability and consistency[J].journal interventional radiology,2011,(12):867.
[12]李建军,郑加生,崔雄伟,等. 肝肿瘤CT引导经皮射频消融术后胆道并发症防治[J].介入放射学杂志,2011,(12):984.
 LI Jian-jun,ZHENG Jia-sheng,CUI Xiong-wei,et al.The prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic neoplasms[J].journal interventional radiology,2011,(12):984.
[13]张学彬,花迎雪,仇晓霞,等. 肝动脉臭氧化碘油栓塞治疗兔VX2肝癌的初步研究[J].介入放射学杂志,2012,(09):760.
 ZHANG Xue- bin,HUA Ying-xue,QIU Xiao- xia,et al. A preliminary study of hepatic arterial embolization with ozonated?蛳 Lipiodol for liver VX2 carcinoma in experimental rabbits[J].journal interventional radiology,2012,(12):760.
[14]陈长广,倪才方,陈 珑. 肝动脉栓塞联合射频消融对兔肝癌模型VEGF及MVD的影响[J].介入放射学杂志,2013,(11):936.
 CHEN Chang? guang,NI Cai? fang,CHEN Long.. Effect of transcatheter arterial chemoembolization together with radiofrequency ablation on VEGF and MVD in rabbit models with hepatic cancer[J].journal interventional radiology,2013,(12):936.
[15]何伟华,独建库,张明德,等. 介入性热灌注联合瘤体注射热碘油对兔VX2肝癌模型的疗效研究[J].介入放射学杂志,2013,(11):940.
 HE Wei? hua,DU Jian? ku,ZHANG Ming? de,et al.The therapeutic effect of interventional heated?蛳 Lipiodol perfusion combined with heated?蛳 Lipiodol injection into tumor for the treatment of VX2 liver cancer in experimental rabbits[J].journal interventional radiology,2013,(12):940.
[16]钱 亭,陈茂振,高 峰,等. 两种方法建立兔VX2肝癌模型的比较及影像学评估[J].介入放射学杂志,2014,(01):58.
 QIAN Ting,CHEN Mao? zhen,GAO Feng,et al. Comparison of two methods used in establishing VX?蛳 2 liver tumor model in rabbits and their imaging evaluation[J].journal interventional radiology,2014,(12):58.
[17]徐守军,杜端明,刘鹏程,等. 肝肿瘤射频消融术后CT表现及其临床意义[J].介入放射学杂志,2014,(01):69.
 XU Shou? jun,DU Duan? ming,LIU Peng? cheng,et al. CT manifestation and its clinical significance of liver tumors after radiofrequency ablation[J].journal interventional radiology,2014,(12):69.
[18]陈文会,杨朝爱,杨继金,等. 曲马多在经皮穿刺肝肿瘤射频消融术中的应用[J].介入放射学杂志,2014,(02):126.
 CHEN Wen? hui,YANG Chao? ai,YANG Ji? jin,et al. Application of tramadol in performing percutaneous radiofrequency ablation for liver neoplasms[J].journal interventional radiology,2014,(12):126.
[19]陈敏华. 超声引导肝肿瘤消融治疗的历史、现状及问题[J].介入放射学杂志,2014,(06):463.
 CHEN Min- hua. Ultrasound- guided hepatic tumor ablation: history, current situation and clinical issues[J].journal interventional radiology,2014,(12):463.

备注/Memo

备注/Memo:
 (收稿日期:2013-06-20)
更新日期/Last Update: