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经动脉博来霉素-碘油栓塞治疗巨大肝血管瘤后出现的肝门部狭窄

Resistant Hilar Stricture Following Transarterial Bleomycin-Lipiodol Embolization for a Large Hepatic Hemangioma.

作者信息

Yau Man Ting Kristina, Thilakanathan Cynthuja, Kim Hyun Jae, Ho Stephen G F, Trasolini Roberto P, Gan S Ian, Segedi Maja

机构信息

Division of Gastroenterology, Department of Medicine, Vancouver General Hospital, Vancouver, Canada.

Division of Interventional Radiology, Department of Radiology, Vancouver General Hospital, Vancouver, Canada.

出版信息

ACG Case Rep J. 2025 Aug 4;12(8):e01793. doi: 10.14309/crj.0000000000001793. eCollection 2025 Aug.

DOI:10.14309/crj.0000000000001793
PMID:40761332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12321459/
Abstract

Symptomatic hepatic hemangiomas are commonly treated by transcatheter arterial embolization as an alternative to surgical resection. Bile duct complications are rare. An 80-year-old woman had a progressive refractory stricture postbleomycin transcatheter arterial chemoembolization. Magnetic resonance cholangiopancreatography showed that the hemangioma reduced in size, but there was a new 2 cm hilar stricture on cholangiopancreatography. Digital cholangioscopy and biopsy showed benign changes. Despite repeat dilations and stent treatments, she had persistent stricture and recurrent cholangitis. The stricture was not operable. The stricture was likely from angiosclerotic effects of bleomycin. The bile duct is prone to ischemic injury as it lacks dual blood supply.

摘要

有症状的肝血管瘤通常采用经导管动脉栓塞术治疗，作为手术切除的替代方法。胆管并发症很少见。一名80岁女性在博来霉素经导管动脉化疗栓塞术后出现进行性难治性狭窄。磁共振胰胆管造影显示血管瘤缩小，但胰胆管造影显示有一个新的2厘米肝门部狭窄。电子胆管镜检查和活检显示为良性改变。尽管反复进行扩张和支架治疗，她仍有持续性狭窄和复发性胆管炎。该狭窄无法手术治疗。该狭窄可能是博来霉素的血管硬化作用所致。胆管由于缺乏双重血液供应，容易发生缺血性损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/2fd85c80e588/ac9-12-e01793-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/d4a6ec8a26fb/ac9-12-e01793-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/bebc632c0884/ac9-12-e01793-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/0303ffa82533/ac9-12-e01793-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/e55a77ee7b8d/ac9-12-e01793-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/2fd85c80e588/ac9-12-e01793-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/d4a6ec8a26fb/ac9-12-e01793-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/bebc632c0884/ac9-12-e01793-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/0303ffa82533/ac9-12-e01793-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/e55a77ee7b8d/ac9-12-e01793-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9780/12321459/2fd85c80e588/ac9-12-e01793-g005.jpg

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本文引用的文献

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Transarterial Bleomycin-Lipiodol Chemoembolization for the Treatment of Giant Hepatic Hemangiomas: An Assessment of Effectiveness.经动脉注射博来霉素-碘油化疗栓塞术治疗巨大肝血管瘤：疗效评估
Cancers (Basel). 2024 Jan 16;16(2):380. doi: 10.3390/cancers16020380.
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Medium and Long-Term Outcome of Superselective Transcatheter Arterial Embolization with Lipiodol-Bleomycin Emulsion for Giant Hepatic Hemangiomas: Results in 241 Patients.使用碘油-博来霉素乳剂超选择性经导管动脉栓塞治疗巨大肝血管瘤的中长期结果：241例患者的结果
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Giant hepatic hemangioma treatment with transcatheter arterial embolisation and transcatheter arterial chemoembolisation; Comparative results.
巨块型肝血管瘤经导管动脉栓塞术和经导管动脉化疗栓塞术治疗;比较结果。
Turk J Med Sci. 2021 Dec 13;51(6):2943-2950. doi: 10.3906/sag-2102-352.
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J Surg Case Rep. 2017 Jun 24;2017(6):rjx118. doi: 10.1093/jscr/rjx118. eCollection 2017 Jun.
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