Soyer P, Van Beers B, Goffette P, Zeitoun G, Pringot J, Levesque M
Service de Radiologie, Hôpital Louis-Mourier, Colombes.
Gastroenterol Clin Biol. 1993;17(10):643-8.
Twelve caucasian patients with intraperitoneal hemorrhage due to spontaneous rupture of hepatocellular carcinoma were treated by emergency transcatheter arterial embolization (n = 9) or chemoembolization (n = 3). Pretreatment angiography showed active bleeding (extravasation of contrast medium) in two patients only. Successful hemostasis was initially achieved in all patients. Early recurrence of hemorrhage was noted in 3 patients with large tumors; two were successfully treated by a second embolization and one died immediately after the first embolization. Of the 12 patients, two underwent subsequent chemoembolization while two had surgical resection of their tumors. The mean length of survival was 7 months from the time of rupture. No serious complications related to embolization or chemoembolization were noted. Our data suggest that emergency embolization or chemoembolization is an effective treatment in caucasian patients with intraperitoneal hemorrhage from hepatocellular carcinoma. Prognosis of ruptured hepatocellular carcinoma in those patients, however, remains poor.
12例因肝细胞癌自发破裂导致腹腔内出血的白种患者接受了急诊经导管动脉栓塞术(9例)或化疗栓塞术(3例)治疗。术前血管造影仅显示2例有活动性出血(造影剂外渗)。所有患者最初均成功止血。3例肿瘤较大的患者出现早期出血复发;2例通过再次栓塞成功治疗,1例在首次栓塞后立即死亡。12例患者中,2例随后接受了化疗栓塞,2例接受了肿瘤手术切除。自破裂之时起,平均生存时间为7个月。未发现与栓塞或化疗栓塞相关的严重并发症。我们的数据表明,急诊栓塞或化疗栓塞是治疗肝细胞癌腹腔内出血白种患者的有效方法。然而,这些患者中破裂肝细胞癌的预后仍然很差。