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[介入放射学在肝移植术前和术后阶段的作用]

[Role of intrventional radiology in pre- and postoperative periods of liver transplantation].

作者信息

Granov A M, Tarazov P G, Granov D A, Polysalov V N, Polikarpov A A, Generalov M I, Zherebtsov F K

出版信息

Khirurgiia (Mosk). 2010(3):31-6.

Abstract

The purpose of this study was to prove the use of interventional radiological procedures before and after liver transplantation (LT). Between 1998 and 2009 years, 54 LT were performed in 52 patients. 18 patients received 19 interventional radiological treatments including 11 preoperative (trans-catheter oily chemoembolization of hepatocellular carcinoma, n=3; transjugular intrahepatic portosystemic shunting, n=8) and 8 postoperative (drainage or stenting of biliary strictures, n=4; balloon dilatation and/or stenting of inferior vena cava or cava-caval anastomosis, n=3; splenic artery embolization in sleal syndrome, n=1). It is concluded that before LT, trans-catheter embolization delays the growth of hepatoma and prolongs time for donor liver waiting. Transjugular portosystemic shunt decreases the risk of fatal variceal bleeding. Post-LT complications such as vascular or biliary strictures and steal syndrome can be also effectively corrected by methods of interventional radiology.

摘要

本研究的目的是证实肝移植(LT)前后介入放射学程序的应用。1998年至2009年期间,对52例患者实施了54次肝移植。18例患者接受了19次介入放射学治疗,其中包括11次术前治疗(肝细胞癌经导管油性化疗栓塞,n = 3;经颈静脉肝内门体分流术,n = 8)和8次术后治疗(胆管狭窄引流或支架置入,n = 4;下腔静脉或腔静脉吻合口球囊扩张和/或支架置入,n = 3;脾动脉栓塞治疗窃血综合征,n = 1)。结论是,肝移植前,经导管栓塞可延缓肝癌生长并延长供肝等待时间。经颈静脉门体分流可降低致命性静脉曲张出血的风险。肝移植后的并发症,如血管或胆管狭窄以及窃血综合征,也可通过介入放射学方法有效纠正。

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