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[一例胆管重建术后转移性肝癌射频消融(RFA)后败血症尸检病例]

[An autopsy case of sepsis following radiofrequency ablation (RFA) for metastatic liver carcinoma after bile duct reconstruction].

作者信息

Yamamoto Koutaro, Yahara Noboru, Kawaoka Tooru, Hayashi Hideto, Hazama Shoichi, Tangoku Akira, Oka Masaaki

机构信息

Dept. of Digestive Surgery and Surgical Oncology, Yamaguchi University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2002 Nov;29(12):2238-41.

Abstract

An autopsy case of sepsis following radiofrequency ablation (RFA) for metastatic liver carcinoma after bile duct reconstructive operation is reported. A 72-year-old man underwent pylorus-preserving pancreaticoduodenectomy and reconstruction with the Suzuki-method (PD-III) for extrahepatic bile duct cancer in October 1998. A metastatic lesion was recognized in the liver (S3) in November 2001. Percutaneous RFA was performed for a recurrent lesion. A metastatic lesion was recognized again in the same segment in February 2002. Percutaneous RFA was performed again on February 26 and March 12. The patient was discharged without hemorrhage, infection, or hepatic failure on March 22. He complained of general fatigue on March 26. He was diagnosed with liver abscess, sepsis, acute renal failure, and disseminated intravascular coagulation, and received intensive care, but died on April 1. The autopsy revealed liver necrotic abscess at the RFA locus and multiple microabscesses of the liver, heart, and kidney.

摘要

报告了一例胆管重建术后转移性肝癌经射频消融(RFA)治疗后发生败血症的尸检病例。一名72岁男性于1998年10月接受了保留幽门的胰十二指肠切除术,并采用铃木法(PD-III)进行了肝外胆管癌重建。2001年11月在肝脏(S3)发现一个转移病灶。对复发病灶进行了经皮RFA治疗。2002年2月在同一肝段再次发现转移病灶。于2月26日和3月12日再次进行经皮RFA治疗。患者于3月22日无出血、感染或肝衰竭出院。3月26日,他诉说全身乏力。他被诊断为肝脓肿、败血症、急性肾衰竭和弥散性血管内凝血,并接受了重症监护,但于4月1日死亡。尸检显示RFA部位有肝坏死性脓肿,肝脏、心脏和肾脏有多个微脓肿。

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