肝胆汁瘤的介入治疗

The interventional treatment of intrahepatic bilomas

目的探讨肝胆汁瘤的形成原因及介入治疗。方法 2005年至2010年南通市第一人民医院介入科共收治15例胆汁瘤患者,并行介入治疗,其中11例为TACE术后所致,1例外伤引起,3例外科手术引起。治疗方法是通过B超引导下穿刺置管引流,术后间歇应用敏感抗生素冲洗,通过引流液量的变化及影像学资料观察胆汁瘤愈合情况。结果 15例患者均行引流术,其中8例患者引流30 d内胆汁瘤愈合拔管,2例30～60 d愈合拔管,3例60 d后拔管,1例施行肝移植,1例未能拔管并因肿瘤进展死亡。结论胆汁瘤是肝胆手术、外伤和肝脏介入治疗等所致的一种并发症,介入治疗肝胆汁瘤创伤小、安全有效。

Objective To explore the interventional treatment and the etiologic causes of intrahepatic bilomas.Methods During the period of 2005-2010,a total of 15 patients with intrahepatic bilomas were treated with interventional therapy.The causes of bilomas included TACE procedure（n = 11）,trauma（n = 1） and surgery（n = 3）.Under ultrasound guidance,puncturing together with catheter insertion was accomplished,then continuous drainage was carried out in all patients.Washing of the biloma cavity with antibiotics was performed in all cases.The changes in draining amount and the imaging findings were observed to judge the healing condition of the intrahepatic bilomas.Results After the drainage treatment the bilomas were closed within 30 days（n = 8）,or within 30 to 60 days（n = 2） or after 60 days（n = 3）,and the drainage tubes were then removed.In the remaining two cases,liver transplantation was adopted in one and death due to tumor deterioration occurred in another.Conclusion Intrahepatic biloma is a kind of complication caused by surgical operation,trauma,TACE,etc.The interventional therapy is minimally-invasive,safe and effective for the treatment of intrahepatic bilomas.