CAJ | 학술논문

目的：探讨经皮球囊扩张治疗先天性胆总管囊肿术后门脉海绵样变的应用价值。方法回顾性分析6例先天性胆总管囊肿术后门脉海绵样变的患者资料，术前所有患者均表现不同程度呕血等症状。采用经皮球囊扩张治疗，球囊扩张治疗后再次造影如发现胃冠状静脉仍明显扩张则以弹簧圈栓塞。对患者的临床、影像资料及介入治疗的并发症等情况进行分析，并随访。结果6例患者中5例门脉主干闭塞，1例局限性重度狭窄，所有患者均出现门脉海绵样变。5例患者均成功实行经皮球囊扩张术，其中2例患者联合行胃冠状静脉栓塞术。1例患者因门脉主干合并左右分支近端闭塞，无法打通门脉。所有患者术后均未发生治疗相关严重的并发症。随访3～31个月，5例患者门静脉主干通畅，均无再发生呕血等症状。结论先天性胆总管囊肿术后门脉海绵样变经皮球囊扩张治疗是一种安全、有效、微创的治疗手段。
목적：탐토경피구낭확장치료선천성담총관낭종술후문맥해면양변적응용개치。방법회고성분석6례선천성담총관낭종술후문맥해면양변적환자자료，술전소유환자균표현불동정도구혈등증상。채용경피구낭확장치료，구낭확장치료후재차조영여발현위관상정맥잉명현확장칙이탄황권전새。대환자적림상、영상자료급개입치료적병발증등정황진행분석，병수방。결과6례환자중5례문맥주간폐새，1례국한성중도협착，소유환자균출현문맥해면양변。5례환자균성공실행경피구낭확장술，기중2례환자연합행위관상정맥전새술。1례환자인문맥주간합병좌우분지근단폐새，무법타통문맥。소유환자술후균미발생치료상관엄중적병발증。수방3～31개월，5례환자문정맥주간통창，균무재발생구혈등증상。결론선천성담총관낭종술후문맥해면양변경피구낭확장치료시일충안전、유효、미창적치료수단。
Objective To evaluate the therapeutic efficacy of percutaneous transhepatic portal vein balloon angioplasty in treating cavernous transformation of portal vein following operation of congenital choledochal cyst. Methods From 2012 to 2014, a total of 6 patients with cavernous transformation of portal vein which occurred after the operation of congenital choledochal cyst were encountered at authors’ hospital. The clinical data were retrospectively analyzed. Before treatment, all patients presented symptoms of different degrees of hematemesis. Percutaneous transhepatic portal vein balloon angioplasty was carried out in all patients, and embolization of gastric coronary vein with coils was employed if angiography showed that coronary vein of stomach was pronouncedly dilated. The clinical manifestations, the imaging materials and the complications were analyzed. All the patients were followed up for 3 - 31 months. Results Of the 6 patients, portal vein main stem occlusion was found in 5 and severe localized stenosis was seen in one. Cavernous transformation of portal vein was revealed in all the 6 patients. Percutaneous transhepatic portal vein balloon angioplasty was successfully accomplished in 5 patients and failed in one patient. Embolization of gastric coronary vein with coils was performed in two patients. After the treatment, no treatment-related severe complications occurred in all patients. The follow-up period ranged from 3 to 31 months. During the follow-up period portal vein maintained patent in 5 patients. No recurrent hematemesis occurred in all patients. Conclusion For the treatment of cavernous transformation of portal vein occurring after the operation of congenital choledochal cyst, percutaneous transhepatic portal vein balloon angioplasty is a safe, effective and minimally - invasive therapeutic means.