Section of Vascular and Interventional Radiology, Dartmouth-Hitchcock Medical Center and Norris Cotton Cancer Center, One Medical Center Drive, Lebanon, NH 03756, USA.
J Vasc Interv Radiol. 2009 Dec;20(12):1633-7. doi: 10.1016/j.jvir.2009.09.001. Epub 2009 Oct 24.
Intraoperative radiation therapy (RT) may improve outcomes after pancreaticoduodenectomy for periampullary cancer; however, there is a 20% risk of late portomesenteric venous obstruction. This retrospective study evaluated the percutaneous treatment of portomesenteric venous obstruction that occurred a mean of 10 months after pancreaticoduodenectomy and intraoperative RT. Five patients with medically refractory ascites and portomesenteric obstruction on computed tomographic angiography had successful recanalization with elimination of the pressure gradient and no procedural complications. One patient showed no improvement clinically. Recurrent ascites after stent occlusion was successfully treated in two patients. Percutaneous transhepatic recanalization appears to be a safe and effective therapy in this population.
术中放射治疗（RT）可能会改善胰十二指肠切除术治疗壶腹周围癌的预后；然而，术后有 20%的患者会发生迟发性门腔静脉阻塞。本回顾性研究评估了在胰十二指肠切除术中放疗后平均 10 个月发生的门腔静脉阻塞的经皮治疗。5 例经 CT 血管造影检查发现药物难治性腹水和门腔静脉阻塞的患者成功地进行了再通，消除了压力梯度，且无手术并发症。1 例患者临床症状无改善。2 例支架闭塞后复发性腹水患者经治疗后成功消退。经皮经肝再通术在该人群中似乎是一种安全有效的治疗方法。
