Yu Ming-an, Liang Ping, Yu Xiao-ling, Cheng Zhi-gang, Han Zhi-yu, Liu Fang-yi, Yu Jie
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2013 Feb 19;93(7):516-9.
To explore the complications and clinical outcome of liver metastatic cholangiocarcinoma after microwave ablation (MWA) in patients with a history of pancreatoduodenectomy or liver resection with bilioenteric anastomosis.
Retrospective study was made on 10 lesions of intra-hepatic metastatic cholangiocarcinoma undergoing MWA (range: 1.5 - 3.6 cm, mean: 3.3 ± 1.3 cm) in 6 patients (5 males and 1 female) from February 2008 to October 2011. All had a history of surgical resection for primary neoplasm and bilioenteric anastomosis. Four cases had intrahepatic biliary dilatation pneumatosis.
All lesions were completely ablated according to the results of contrast-enhanced ultrasound (CEUS) or contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) at Month 1 post-MWA. Liver abscess and fistula occurred in 5 ablation zones (5/10) of 4 patients. Three cases were satisfactorily cured with antibiotic dosing, catheter drainage and supportive care. One case died 13 days after MWA. The overall 1, 2, 3-year survival rates of were 64.8%, 21.6% and 21.0% respectively (median: 15.7 months).
A high technical success rate of MWA is obtained in the treatment of intrahepatic metastatic cholangiocarcinoma with bilioenteric anastomosis. However, the incidence of abscess formation remains high due to a coexistence of multiple risk factors.
探讨有胰十二指肠切除术或肝切除联合胆肠吻合术病史的患者，肝转移性胆管癌行微波消融（MWA）后的并发症及临床结局。
回顾性研究2008年2月至2011年10月间6例患者（5例男性，1例女性）的10个肝内转移性胆管癌病灶行MWA治疗的情况（范围：1.5 - 3.6 cm，平均：3.3±1.3 cm）。所有患者均有原发性肿瘤手术切除及胆肠吻合术病史。4例有肝内胆管扩张积气。
根据MWA后1个月的超声造影（CEUS）或增强计算机断层扫描/磁共振成像（CT/MRI）结果，所有病灶均完全消融。4例患者的5个消融区（5/10）发生肝脓肿和瘘管。3例经抗生素给药、导管引流及支持治疗后治愈。1例在MWA后13天死亡。1、2、3年总生存率分别为64.8%、21.6%和21.0%（中位数：15.7个月）。
MWA治疗胆肠吻合术后肝内转移性胆管癌技术成功率高。然而，由于多种危险因素并存，脓肿形成的发生率仍然很高。
