Shibata Toshiya, Sagoh Tadashi, Ametani Fumie, Maetani Yoji, Itoh Kyo, Konishi Junji
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyoku, Kyoto, 606-8507, Japan.
Cardiovasc Intervent Radiol. 2002 May-Jun;25(3):180-5. doi: 10.1007/s00270-001-0106-7. Epub 2002 May 20.
To evaluate the outcome of transcatheter microcoil embolotherapy for bleeding pseudoaneurysms complicating major pancreatic and biliary surgery.
Over an 8-year period, 8 patients were encountered who developed massive bleeding from pseudoaneurysms 15-64 days (mean 31 days) following major pancreatic and biliary surgery. Urgent transcatheter microcoil embolotherapy was performed in all 8 patients.
Transcatheter embolotherapy was successful in 7 of 8 patients (88%) but failed in one due to development of disseminated intravascular coagulation. One patient developed recurrent bleeding 36 days after the first embolotherapy from a newly developed pseudoaneurysm, which was again treated successfully with embolization. Two patients subsequently underwent additional surgery for residual pathology. Three of the 7 patients with successful embolotherapy were alive at 10-96 months, 4 patients died of associated malignancies 4-20 months after embolotherapy.
Transcatheter microcoil embolotherapy is effective for bleeding pseudoaneurysms complicating pancreatic and biliary surgery, and should be considered the first treatment of choice.
评估经导管微线圈栓塞疗法治疗胰腺和胆道大手术并发出血性假性动脉瘤的疗效。
在8年期间，共遇到8例患者，他们在胰腺和胆道大手术后15 - 64天（平均31天）出现假性动脉瘤大量出血。所有8例患者均接受了紧急经导管微线圈栓塞治疗。
8例患者中有7例（88%）经导管栓塞治疗成功，但1例因发生弥散性血管内凝血而失败。1例患者在首次栓塞治疗36天后，因新出现的假性动脉瘤再次出血，再次栓塞治疗成功。2例患者随后因残留病变接受了额外手术。7例栓塞治疗成功的患者中有3例在10 - 96个月时存活，4例患者在栓塞治疗后4 - 20个月死于相关恶性肿瘤。
经导管微线圈栓塞疗法对胰腺和胆道手术并发的出血性假性动脉瘤有效，应被视为首选的治疗方法。
