Shibata Toshiya, Sagoh Tadashi, Maetani Yoji, Ametani Fumie, Kubo Takeshi, Itoh Kyo, Konishi Junji
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyoku, Kyoto, 606-8507, Japan.
Hepatogastroenterology. 2003 Jul-Aug;50(52):1119-23.
BACKGROUND/AIMS: Advanced hepatocellular carcinoma usually invades the portal vein, forming tumor thrombi. Invasion of the bile duct, i.e., intrabile tumor growth or bile duct tumor thrombi is rare. Patients with bile duct tumor thrombi present with obstructive jaundice, abdominal pain or hemobilia. Hemobilia due to bile duct tumor thrombi is sometimes massive and fatal. The purpose of our study was to evaluate the effectiveness of transcatheter arterial embolization for hemobilia caused by bile duct tumor thrombi of hepatocellular carcinoma.
Between 1993 January and 2000 December, transcatheter arterial embolization was performed in 4 patients with hemobilia and gastrointestinal bleeding from bile duct tumor thrombi of hepatocellular carcinoma.
In all 4 patients, transcatheter arterial embolization was successfully performed and resulted in cessation of bleeding. One patient had recurrent hemobilia, which was controlled by another transcatheter arterial embolization. Three patients were discharged from hospital after transcatheter arterial embolization. Patients died of hepatic failure or multiple tumors 5 to 7 months after the onset of hemobilia, although hemobilia had been fully controlled.
Transcatheter arterial embolization seemed to be effective for the control of massive hemobilia caused by bile duct tumor thrombi associated with hepatocellular carcinoma.
背景/目的：晚期肝细胞癌通常侵犯门静脉，形成肿瘤血栓。胆管侵犯，即胆管内肿瘤生长或胆管肿瘤血栓较为罕见。胆管肿瘤血栓患者表现为梗阻性黄疸、腹痛或胆道出血。由胆管肿瘤血栓引起的胆道出血有时量很大且会致命。我们研究的目的是评估经导管动脉栓塞术对肝细胞癌胆管肿瘤血栓所致胆道出血的疗效。
1993年1月至2000年12月期间，对4例因肝细胞癌胆管肿瘤血栓导致胆道出血和胃肠道出血的患者实施了经导管动脉栓塞术。
所有4例患者经导管动脉栓塞术均成功实施，出血停止。1例患者复发出血，经再次经导管动脉栓塞术得到控制。3例患者经导管动脉栓塞术后出院。尽管胆道出血已得到完全控制，但患者在胆道出血发作后5至7个月死于肝衰竭或多发肿瘤。
经导管动脉栓塞术似乎对控制与肝细胞癌相关的胆管肿瘤血栓所致的大量胆道出血有效。
