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[1例因肝动脉灌注化疗导致胆管梗阻和胆总管结石的胃癌肝转移病例]

[A case of gastric cancer with liver metastasis in which obstruction of the bile duct and choledocholithiasis was caused by intra-hepatic arterial infusion chemotherapy].

作者信息

Yamaguchi Kazuya, Miyashita Kaoru, Aizawa Kikuo, Todoroki Hidekazu, Kiyonaga Hidetoshi

机构信息

Dept. of Surgery, Tsubame Rosai Hospital.

出版信息

Gan To Kagaku Ryoho. 2003 Apr;30(4):523-6.

Abstract

A 64-year-old man underwent gastrectomy and partial liver resection for gastric cancer and liver metastasis, and was administered intra-arterial infusion chemotherapy for metastases of the remnant liver. This treatment was very effective against the liver metastases, but 13 months after the operation obstructive jaundice occurred. An examination revealed obstruction of the bile duct and choledocholithiasis. The choledocholithiasis was treated using a percutaneous transhepatic cholangio-scope, and choledocho-duodenostomy was performed for the obstruction of the bile duct. Findings from the operation suggested that the obstruction was caused by the intra-arterial infusion chemotherapy. At present, 2 years after the first operation, the patient is alive without the regrowth of the liver metastasis.

摘要

一名64岁男性因胃癌伴肝转移接受了胃切除术和部分肝切除术,并接受了针对残余肝转移灶的动脉内灌注化疗。该治疗对肝转移灶非常有效,但术后13个月出现了梗阻性黄疸。检查发现胆管梗阻和胆总管结石。采用经皮经肝胆管镜治疗胆总管结石,并对胆管梗阻进行了胆总管十二指肠吻合术。手术结果提示梗阻是由动脉内灌注化疗引起的。目前,首次手术后2年,患者存活,肝转移未复发。

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