CAJ | 학술논문

目的探讨肝脏恶性肿瘤经导管肝动脉化疗栓塞术后并发肝内胆管损伤的影像学表现及临床诊治方法.方法收集2007年9月至2009年3月因肝脏恶性肿瘤行经导管肝动脉化疗栓塞术1302例的临床资料,术前影像学检查均无明显胆道异常,观察术后肝内胆管影像学征象及临床表现.结果 6例经导管肝动脉化疗栓塞术后随访1至3个月出现肝内胆管损伤,其中2例出现黄疸、高热等胆道梗阻、感染症状,采用经皮经肝胆道穿刺引流术后症状缓解;其余4例仅有影像学改变,无明显临床症状.结论肝内胆管损伤是经导管肝动脉化疗栓塞术后少见的并发症,诊断依赖于临床表现及影像学检查,经皮经肝胆道穿刺引流术是有症状的肝内胆管损伤的有效治疗方式.
목적 탐토간장악성종류경도관간동맥화료전새술후병발간내담관손상적영상학표현급림상진치방법.방법 수집2007년9월지2009년3월인간장악성종류행경도관간동맥화료전새술1302례적림상자료,술전영상학검사균무명현담도이상,관찰술후간내담관영상학정상급림상표현.결과 6례경도관간동맥화료전새술후수방1지3개월출현간내담관손상,기중2례출현황달、고열등담도경조、감염증상,채용경피경간담도천자인류술후증상완해;기여4례부유영상학개변,무명현림상증상.결론 간내담관손상시경도관간동맥화료전새술후소견적병발증,진단의뢰우림상표현급영상학검사,경피경간담도천자인류술시유증상적간내담관손상적유효치료방식.
Objective To evaluate CT findings, diagnosis and management of intrahepatic biliary injuries after transcatheter arterial chemoembolization (TACE) for liver malignancies. Methods A total of 1302 patients with hepatic malignant tumors received TACE between Sep 2007 and Mar 2009. None of these patients were found to have any radiographic evidence of biliary abnormalities before TACE. A retrospective review of imaging studies and clinical outcomes was carried out to evaluate the changes of intrahepatic biliary injuries after TACE. Results Six patients developed intrahepatic biliary injuries during 1 and 3-month follow-up. Two cases with jaundice and high fever, underwent percutaneous transhepatic cholangiography and drainage and eventually recovered. The other 4 patients were asymptomatic with only radiographic changes and were managed observationally. Conclusions Intrahepatic biliary injury is a rare complicating TACE procedures. It will be identified by clinical outcomes and radiographic imaging findings. Percutaneous transhepatic cholangiography and drainage (PTCD) is the therapy of choice for intrahepatic biliary injuries with jaundice or high fever.