Richardet J P, Lons T, Sibony M, Choury A, Ajavon Y, Coderc E, Grimbert S, Hecht Y, Beaugrand M
Service d'Hépato-Gastroentérologie, Hôpital Jean-Verdier, Bondy.
Gastroenterol Clin Biol. 1994;18(2):168-71.
Two cases of sclerosing cholangitis after oily arterial chemoembolization are reported. In one patient angiocholitis with liver abscesses, in the other patient gradual cholestasis were the main clinical features. In both cases, endoscopic retrograde cholangiogram showed a stricture of the common hepatic bile duct and, in one case, irregularities of intrahepatic biliary tree. Histologic examination of the liver in the two patients pointed out the involvement of small bile ducts and arteriolar endarteritis obliterans. Ischaemia is likely to be the main mechanism of these two cases of sclerosing cholangitis as well as in those described after FUDR intra-arterial chemotherapy. The prevalence of sclerosing cholangitis after arterial oily chemoembolization is probably underestimated because of a non specific clinical presentation and need to be precise by further study.
报告了两例油性动脉化疗栓塞术后硬化性胆管炎的病例。其中一例患者主要临床表现为血管性胆管炎伴肝脓肿,另一例患者主要表现为进行性胆汁淤积。两例患者的内镜逆行胆管造影均显示肝总管狭窄,其中一例肝内胆管树不规则。两名患者肝脏的组织学检查均显示小胆管受累及小动脉闭塞性动脉内膜炎。缺血可能是这两例硬化性胆管炎以及氟尿苷动脉内化疗后所描述病例的主要机制。由于临床表现不具特异性,动脉油性化疗栓塞术后硬化性胆管炎的患病率可能被低估,需要进一步研究以明确。