Tsuji Y, Nishimura A, Yasuda T, Katsuki Y
Dept. of Surgery, JSW Memorial Hospital.
Gan To Kagaku Ryoho. 1988 Aug;15(8 Pt 2):2520-4.
A case of hepatoma with cirrhosis for whom hepatectomy was impossible because of a severe complication is reported. The case has been treated with various treatments, so long survival has been obtained. The patient is a 56-year-old female with hepatoma with cirrhosis. The initial symptom was bleeding from esophageal varices. Her condition was not suitable for hepatectomy because of hypersplenism and remarkable hepatic disorder. Consequently, she was given endoscopic sclerotherapy for esophageal varices, partial splenic embolization for hypersplenism, and transarterial embolization with ADM, Lipiodol and Spongel powder for hepatoma. Although abdominal pain, pleural effusion and bleeding from gastric ulcer appeared after embolization, esophageal varices and hypersplenism were significantly improved; reduction of 75% of hepatoma was observed and AFP decreased from 18.7 ng to 3 ng. At 12 months after the embolization, there is no sign of hepatoma growth, rupture of esophageal varices or hypersplenism.
报告了一例因严重并发症无法进行肝切除术的肝癌合并肝硬化病例。该病例接受了多种治疗,获得了较长时间的生存。患者为一名56岁患有肝癌合并肝硬化的女性。最初症状为食管静脉曲张出血。由于脾功能亢进和明显的肝脏疾病,她的病情不适合进行肝切除术。因此,她接受了食管静脉曲张的内镜硬化治疗、脾功能亢进的部分脾栓塞以及肝癌的经动脉用阿霉素、碘油和明胶海绵粉栓塞治疗。尽管栓塞后出现了腹痛、胸腔积液和胃溃疡出血,但食管静脉曲张和脾功能亢进明显改善;观察到肝癌缩小了75%,甲胎蛋白从18.7纳克降至3纳克。栓塞后12个月,没有肝癌生长、食管静脉曲张破裂或脾功能亢进的迹象。