经导管动脉化疗栓塞术治疗肝细胞癌后碘化油致胆总管阻塞：1 例报告。
Common Bile Duct Obstructed by Lipiodol After Transcater Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report.
机构信息
Department of Gastroenterology, Hang Zhou Xixi Hospital, 2 Hengbu Street, Xihu District, Hang Zhou, 310032, China.
出版信息
Curr Med Imaging. 2023;19(14):1689-1695. doi: 10.2174/1573405619666230213145111.
BACKGROUND
Transcatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC), however, the complications of TACE have gradually become a concern of clinicians. Injury to the bile duct has been the focus of many scholars.
CASE PRESENTATION
HCC was diagnosed in a 51-year-old female patient, and the first TACE was performed on April 10, 2020. The second TACE was performed on October 18, 2021. After the second TACE, The patient suffered from nausea, jaundice, and body itching. Computed tomography (CT) of the abdomen showed that the lower common bile duct was obviously blocked by the solidified lipiodol accompanied by dilatation of intrahepatic and extrahepatic bile ducts on October 27, 2021. Endoscopic retrograde cholangiopancretography (ERCP) and endoscopic nasobiliary drainage (ENBD) were performed on October 29, 2021. The deposition of lipiodol in the common bile duct was significantly reduced.
CONCLUSION
After the transcatheter arterial chemoembolization for hepatocellular carcinoma, we should be on alert for damage to the bile duct, and pay attention to the deposition of lipiodol in the common bile duct.
背景
经导管动脉化疗栓塞术（TACE）是治疗肝细胞癌（HCC）的有效方法，然而，TACE 的并发症逐渐成为临床医生关注的焦点。胆管损伤一直是许多学者关注的焦点。
病例介绍
一位 51 岁女性患者被诊断为 HCC，于 2020 年 4 月 10 日首次进行 TACE，2021 年 10 月 18 日进行第二次 TACE。第二次 TACE 后，患者出现恶心、黄疸和身体瘙痒。腹部 CT 显示 2021 年 10 月 27 日胆总管下段被固化的碘油明显堵塞，伴肝内外胆管扩张。2021 年 10 月 29 日进行了内镜逆行胰胆管造影术（ERCP）和内镜鼻胆管引流术（ENBD），胆管内碘油沉积明显减少。
结论
经导管动脉化疗栓塞治疗肝细胞癌后，应警惕胆管损伤，并注意胆总管内碘油沉积。
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