Kishimoto W, Nakao A, Takagi H, Hayakawa T
Second Department of Surgery, Nagoya University School of Medicine, Japan.
Am J Gastroenterol. 1989 Nov;84(11):1396-9.
Transcatheter arterial embolization (TAE) has been widely used for treatment of hepatocellular carcinoma. Acute pancreatitis occasionally occurs as a complication of TAE. We have investigated the possible effects of TAE on the pancreas by monitoring serum pancreatic enzyme activities following TAE with various embolic materials. Serum amylase activity was increased very little in the patients treated with chemotherapy alone or plus TAE with lipiodol, slightly increased in many of the patients treated with chemotherapy plus TAE with gelatin sponge, and increased in all of the patients treated with chemotherapy plus TAE with gelfoam powder. The activity was increased to a level as high as 700 U/dl or more in most individuals of the last category. In one of them acute pancreatitis developed, probably because the gelfoam powder regurgitated into the pancreaticoduodenal artery, and occluded a very peripheral portion of the pancreatic vascular bed, leading to ischemia of the pancreas. These results suggest that choosing the correct particle size is important for prevention of acute pancreatitis.
经导管动脉栓塞术（TAE）已被广泛用于治疗肝细胞癌。急性胰腺炎偶尔会作为TAE的并发症出现。我们通过监测使用各种栓塞材料进行TAE后血清胰酶活性，研究了TAE对胰腺可能产生的影响。单独接受化疗或化疗加碘油TAE治疗的患者血清淀粉酶活性升高很少，化疗加明胶海绵TAE治疗的许多患者血清淀粉酶活性略有升高，化疗加明胶海绵粉末TAE治疗的所有患者血清淀粉酶活性均升高。在最后一组的大多数个体中，该活性升高至高达700 U/dl或更高的水平。其中一名患者发生了急性胰腺炎，可能是因为明胶海绵粉末反流至胰十二指肠动脉，并阻塞了胰腺血管床的非常外周部分，导致胰腺缺血。这些结果表明，选择正确的颗粒大小对于预防急性胰腺炎很重要。
