Nambu T, Yoshikawa H, Shirato H, Suzuki K, Kikuchi H, Akikawa K
Dept. of Radiology, Obihiro Kosei Hospital.
Gan No Rinsho. 1990 Nov;36(14):2420-6.
Reviewed and discussed are six cases of intrahepatic biloma that developed after hepatic arterial embolization therapy for malignant hepatic tumors. All six cases were administered emulsion of adriamycin and lipiodol and/or sponge gel particles, as the etiology of their disease was considered to be bile duct necrosis due to obstructions of peripheral supplying arterial branches. From the 23rd to the 76 days after embolization therapy, each lesion was detected by CT scan, and every case showed an elevation of serum alkaline phoshatase. Further, in 4 cases, hepatobiliary scintigraphy revealed a delayed bile clearance in the hepatic lobe. In one case followed up for 2 months, only one of two lesions disappeared. And in 5 cases that were followed up for more than 4 months, recovery occurred in 4 cases without any further treatment, but another case required percutaneous drainage for 3.5 months to be cured. An intrahepatic biloma, or bile duct necrosis, is a complication that can arise from hepatic arterial embolization therapy, so that careful follow-up must be given.
回顾并讨论了6例在恶性肝肿瘤肝动脉栓塞治疗后发生的肝内胆汁瘤病例。所有6例均接受了阿霉素与碘油乳剂和/或海绵凝胶颗粒治疗，因为其病因被认为是由于外周供血动脉分支阻塞导致的胆管坏死。在栓塞治疗后的第23天至76天，通过CT扫描检测到每个病灶，且每例血清碱性磷酸酶均升高。此外，4例患者的肝胆闪烁显像显示肝叶胆汁清除延迟。在1例随访2个月的病例中，2个病灶中只有1个消失。在5例随访超过4个月的病例中，4例未经任何进一步治疗而康复，但另1例需要经皮引流3.5个月才能治愈。肝内胆汁瘤或胆管坏死是肝动脉栓塞治疗可能引发的一种并发症，因此必须进行仔细的随访。
