肝癌伴门静脉癌栓的金属内支架治疗的初步研究

Metallic Stent Treatment of Portal Cancerous Thrombus in Primary Hepatic Carcinoma: A Report of 19 Cases

目的 研究肝癌合并门静脉癌栓的门静脉金属内支架治疗的临床效果。资料与方法 1 9例肝癌门静脉癌栓患者采用穿肝或穿脾途径置入门静脉金属内支架 ,记录手术成功率 ,狭窄开通率 ,并发症和手术死亡率 ,随访支架通畅期和患者生存期。结果 手术成功率为 94 .7% ,狭窄开通率 77.8% ,2例发生肝性脑病、肝功能衰竭。支架中位通畅期 4个月 ,治疗后 3个月、6个月、1年患者生存率分别为 4 3.8% (7/ 1 6 )、2 5 % (4 / 1 6 )、1 2 .5 % (2 / 1 6 )。结论 巨块型肝癌合并门静脉癌栓 。

Objective To discuss the clinical efficiency of metallic stent treatment for portal cancerous thrombus in the patients with primary hepatic carcinoma (PHC). Materials and Methods Cancerous thrombus in the main trunk of the portal vein in 19 cases with PHC was treated with metallic stent. The successful rate of the procedure, the patency of the obstruction, the complications, the mortality and the survival period were recorded.Results The procedure was successfully performed in 18 cases (94.7%), The obstruction was re opened in 77.8% of cases. Hepatic encephalopathy and hepatic failure occurred in two cases. The median patency period of the stent was 4 months. The survival rate at 3, 6 and 12 months after the procedure was 43.8% (7/16), 25% (4/16) and 12.5% (2/16), respectively.Conclusion For cancerous thrombus in the main trunk of the portal vein in PHC patients without distant metastases, metallic stent treatment, with the distal tip of the stent being placed in the non tumorous hepatic lobe, is very effective.