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肝细胞癌射频消融术相关意外伤害所致胆囊积血：一例报告

Hemocholecyst caused by accidental injury associated with radiofrequency ablation for hepatocellular carcinoma: A case report.

作者信息

Tan You-Wen, Zhang Xin-Yue

机构信息

Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China.

出版信息

World J Clin Cases. 2023 Aug 16;11(23):5610-5614. doi: 10.12998/wjcc.v11.i23.5610.

DOI:10.12998/wjcc.v11.i23.5610
PMID:37637692
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10450381/
Abstract

BACKGROUND

Radiofrequency ablation (RFA) is an effective and safe treatment for hepatocellular carcinoma that features a lower incidence of serious complications than surgical resection. Hemocholecyst caused by RFA is a rare complication of secondary damage to the intrahepatic bile duct that results in hemobilia.

CASE SUMMARY

Here we report on a case of a hemocholecyst caused by accidental injury during RFA that induced hematemesis and melena. Digital subtraction angiography revealed no gallbladder arterial injuries. After conservative treatment and transcatheter arterial chemoembolization, the patient's condition stabilized, and she was discharged 1 wk later.

CONCLUSION

Therefore, when performing interventional procedures such as RFA, clinicians must be vigilant because even minor injuries can lead to serious complications such as hemocholecyst.

摘要

背景

射频消融术（RFA）是一种治疗肝细胞癌的有效且安全的方法，其严重并发症的发生率低于手术切除。RFA引起的胆囊积血是肝内胆管继发性损伤导致胆道出血的一种罕见并发症。

病例摘要

在此，我们报告一例RFA术中意外损伤导致胆囊积血并引发呕血和黑便的病例。数字减影血管造影显示无胆囊动脉损伤。经过保守治疗和经导管动脉化疗栓塞后，患者病情稳定，1周后出院。

结论

因此，在进行如RFA等介入操作时，临床医生必须保持警惕，因为即使是轻微损伤也可能导致诸如胆囊积血等严重并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0234/10450381/ba13e1b70038/WJCC-11-5610-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0234/10450381/ba13e1b70038/WJCC-11-5610-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0234/10450381/ba13e1b70038/WJCC-11-5610-g001.jpg

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本文引用的文献

1
Efficacy and safety of percutaneous radiofrequency ablation versus surgical resection for small hepatocellular carcinoma: a meta-analysis of 23 studies.经皮射频消融与手术切除治疗小肝细胞癌的疗效和安全性：23 项研究的荟萃分析。
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Complications of radiofrequency ablation for hepatocellular carcinoma in a multicenter study: An analysis of 16 346 treated nodules in 13 283 patients.多中心研究中射频消融治疗肝细胞癌的并发症：对 13283 例患者的 16346 个治疗结节的分析。
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Radiofrequency ablation versus hepatic resection for the treatment of hepatocellular carcinomas 2 cm or smaller: a retrospective comparative study.
射频消融与肝切除术治疗 2cm 或更小的肝细胞癌：一项回顾性对比研究。
Radiology. 2012 Mar;262(3):1022-33. doi: 10.1148/radiol.11110817.
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Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma: a meta-analysis.射频消融与手术切除治疗小肝癌的临床疗效：荟萃分析。
J Gastroenterol Hepatol. 2012 Jan;27(1):51-8. doi: 10.1111/j.1440-1746.2011.06947.x.
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A case of hemocholecyst associated with hemobilia following radiofrequency ablation therapy for hepatocellular carcinoma.1例肝细胞癌射频消融治疗后并发胆囊积血伴胆道出血的病例。
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6
Is percutaneous radiofrequency thermal ablation of hepatocellular carcinoma a safe procedure?经皮射频热消融治疗肝细胞癌是一种安全的手术吗？
Eur J Gastroenterol Hepatol. 2008 Mar;20(3):196-201. doi: 10.1097/MEG.0b013e3282f1cc4a.
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Hepatology. 2008 Jan;47(1):82-9. doi: 10.1002/hep.21933.
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Major complications of ultrasound-guided percutaneous radiofrequency ablations for liver malignancies: single center experience.超声引导下经皮肝恶性肿瘤射频消融术的主要并发症：单中心经验
J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 2):e445-50. doi: 10.1111/j.1440-1746.2007.05078.x. Epub 2007 Aug 7.
9
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