Ko S, Nakajima Y, Kanehiro H, Aomatsu Y, Yoshimura A, Taki J, Ueno M, Kin T, Nakano H
First Department of Surgery, Nara Medical University, Japan.
Surg Today. 1995;25(6):557-9. doi: 10.1007/BF00311316.
A 63-year-old woman diagnosed as having hepatic hilar cancer underwent an extended left lobectomy of the liver with excision of the right hepatic artery which was involved by the tumor. Because the hepatic artery could not be reconstructed by direct anastomosis, an artificial arterioportal (A-P) shunt was constructed between the common hepatic artery and the portal vein. However, 4 weeks after the operation, portal hypertension with severe esophageal varices developed. Under the diagnosis of portal hypertension caused by excessive blood flow from the A-P shunt, coil embolization of the common hepatic artery was performed using an angiographic technique, following which the esophageal varices completely disappeared. This case demonstrates that portal hypertension after A-P shunting can be effectively treated with coil embolization.
一名被诊断为肝门部癌的63岁女性接受了扩大左肝叶切除术,切除了被肿瘤侵犯的右肝动脉。由于肝动脉无法通过直接吻合重建,遂在肝总动脉和门静脉之间构建了人工动门(A-P)分流。然而,术后4周,出现了伴有严重食管静脉曲张的门静脉高压。在诊断为由A-P分流导致血流过多引起的门静脉高压后,采用血管造影技术对肝总动脉进行了弹簧圈栓塞,随后食管静脉曲张完全消失。该病例表明,A-P分流后门静脉高压可通过弹簧圈栓塞得到有效治疗。