Takagi H, Yamada S, Abe T, Uehara M, Takezawa J, Nagamine T, Ichikawa K, Kobayashi S, Katakai S
Department of Internal Medicine, Maebashi Red Cross Hospital, Japan.
Gastroenterol Jpn. 1989 Jun;24(3):315-9. doi: 10.1007/BF02774330.
A 57-year-old man with hepatocellular carcinoma (HCC) invading the hepatic duct was treated with transcatheter arterial embolization (TAE). The dilated hepatic duct was decompressed his jaundice disappeared and he survived for 10 months after the first TAE, succumbing due to bleeding from gastric erosion. Although total bilirubin was 26.7 mg/dl and massive ascites was noted on occasion of the first TAE, hepatic dysfunction did not worsen and both icterus and ascites decreased, disappearing one month after the therapy. Autopsy revealed HCC with trabecular arrangement originating in the left lobe and growing into the left hepatic duct accompanied by liver cirrhosis and follicular carcinoma of the thyroid gland. Severe icterus caused by bile duct obstruction does not correlate with the grade of hepatic failure in HCC with liver cirrhosis, so TAE was effective and should be tried as a first choice therapy in such a poor risk case.
一名57岁肝细胞癌（HCC）侵犯肝管的男性接受了经导管动脉栓塞术（TAE）治疗。扩张的肝管得到减压，黄疸消失，首次TAE治疗后他存活了10个月，最终因胃糜烂出血死亡。首次TAE治疗时总胆红素为26.7mg/dl，并有大量腹水，但肝功能并未恶化，黄疸和腹水均减轻，治疗后1个月消失。尸检显示，起源于左叶的HCC呈小梁状排列，生长至左肝管，伴有肝硬化和甲状腺滤泡癌。在伴有肝硬化的HCC中，胆管梗阻引起的严重黄疸与肝衰竭程度无关，因此TAE是有效的，在这种高风险病例中应作为首选治疗方法尝试。
