Khoursheed M, Crotch-Harvey M A, Gould D A
Department of Surgery, Broadgreen Hospital NHS Trust, Liverpool.
Clin Radiol. 1994 Nov;49(11):784-6. doi: 10.1016/s0009-9260(05)81967-1.
Primary pancreatic neoplasm typically presents at an advanced stage where surgical management may not be feasible. These patients are often symptomatic due to biliary obstruction but problems may also include gastrointestinal bleeding and endocrinological complications. We describe two cases illustrating the use of palliative embolization in the control of biochemical and haemorrhagic complications of primary pancreatic neoplasm. In one case, massive gastrointestinal bleeding from an inoperable primary pancreatic carcinoma was controlled by two embolization procedures to produce devascularization of the primary lesion. In a second case, life-threatening hypercalcaemia was thought to be due to secretion of a parathormone-like material from an inoperable islet cell tumour. There was no evidence of liver metastases and the pancreatic mass was embolized, following which serum calcium was reduced to near normal levels with considerable clinical improvement. We conclude that there is a role for embolization of inoperable primary pancreatic neoplasm in the palliation of biochemical or haemorrhagic complications of these tumours.
原发性胰腺肿瘤通常在晚期出现，此时手术治疗可能不可行。这些患者常因胆道梗阻出现症状，但问题也可能包括胃肠道出血和内分泌并发症。我们描述了两例说明姑息性栓塞在控制原发性胰腺肿瘤的生化和出血并发症中的应用的病例。在一例中，无法手术切除的原发性胰腺癌导致的大量胃肠道出血通过两次栓塞手术得以控制，使原发病变血管化消失。在另一例中，危及生命的高钙血症被认为是由于无法手术切除的胰岛细胞瘤分泌一种甲状旁腺激素样物质所致。没有肝转移的证据，对胰腺肿块进行了栓塞，随后血清钙降至接近正常水平，临床症状有显著改善。我们得出结论，对于无法手术切除的原发性胰腺肿瘤，栓塞在缓解这些肿瘤的生化或出血并发症方面有一定作用。
