肝动脉栓塞术后严重胆道并发症
Severe biliary complications after hepatic artery embolization.
作者信息
Huang Xiao-Qiang, Huang Zhi-Qiang, Duan Wei-Dong, Zhou Nin-Xing, Feng Yu-Quan
机构信息
Department of Hepatobiliary Surgery, General Hospital of PLA, 28 Fuxing Road, Beijing 100853,China.
出版信息
World J Gastroenterol. 2002 Feb;8(1):119-23. doi: 10.3748/wjg.v8.i1.119.
AIM
To study the mechanism and treatment of severe biliary complications arising from hepatic artery embolization(HAE).
METHODS
Of seven cases of intra- and extrahepatic biliary damage resulting from hepatic artery embolization reported since 1987, 6 patients suffered from hepatic haemangioma, the other case was due to injection of TH compound into the hepatic artery during operation. The hepatic artery was injected with ethanol so as to evaluate the liver damage in experimental rats.
RESULTS
All the cases were found to have destructive damage of intra- and extrahepatic bile duct at the hilum with biliary hepatocirrhosis. Experimental results revealed necrosis of the liver parenchyma, especially around the portal tract and obliteration of intrahepatic bile duct.
CONCLUSIONS
To prevent the severe biliary complications of HAE, the use of HAE for hepatic haemangioma which was widely practiced in China, should be re-evaluated. Hepatic arterial embolization of hepatic haemangioma may resulte in severe destructive biliary damages and its indiscriminate use should be prohibited.
目的
研究肝动脉栓塞术（HAE）引起严重胆道并发症的机制及治疗方法。
方法
自1987年以来报道的7例因肝动脉栓塞导致肝内外胆管损伤的病例中，6例患有肝血管瘤，另1例是由于术中向肝动脉注射TH化合物所致。向实验大鼠肝动脉注射乙醇以评估肝损伤情况。
结果
所有病例均发现肝门处肝内外胆管有破坏性损伤并伴有胆汁性肝硬化。实验结果显示肝实质坏死，尤其是门静脉周围，肝内胆管闭塞。
结论
为预防HAE的严重胆道并发症，在中国广泛应用的肝血管瘤肝动脉栓塞术应重新评估。肝血管瘤的肝动脉栓塞可能导致严重的破坏性胆道损伤，应禁止滥用。
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