肝癌TACE术后胆汁瘤的形成原因及治疗

Analysis of Reasons,Diagnosis and Treatment of Hepatic Tumors Patients with Biloma after TACE

目的探讨肝癌TACE(transcatheter arterial chemoembolization)术后胆汁瘤的形成原因及处理方法。方法选取经TACE治疗后形成胆汁瘤的18例肝癌患者,记录其黄疸症状、TACE次数、胆汁瘤形成时间、治疗手段及预后。结果18例肝癌患者中有12例患者在胆汁瘤形成前出现了不同程度的黄疸症状。TACE次数为1~6次,平均3.5次。胆汁瘤形成于末次TACE后2~5周,平均3.46周。1例患者经保守治疗后病情好转;1例患者正在动态观察;3例经B超穿刺抽出胆汁治愈;13例患者行PTCD(percutaneous transhepatic choledochus drainage),术后10例出现好转、黄疸消失,1例患者肾衰竭死亡,2例未见明显好转。结论多次介入治疗可能是诱发胆汁瘤的主要原因,胆汁瘤预后情况总体良好。

Objective To analyze the reasons ,diagnosis and treatment of hepatic tumors patients with biloma after tran-scatheter arterial chemoembolization (TACE).Methods Jaundice,TACE,biloma formation time,treatment and prognosis of 18 cases of hepatic tumor patients complicated with biloma after TACE were recorded .Results Among these 18 cases of hepatic tumors,12 cases had different levels of jaundice before biloma formation .The TACE were 1 to 6 times,mean 3.5 times.The bilo-ma occurred at about 2 to 5 weeks after last TACE,mean 3.46 weeks.1 case became better after conservative treatment;1 case was under dynamic observation;3 cases were cured after B ultrasound puncture of bile;13 cases were given PTCD ( percutaneous transhepatic choledochus drainage ) ,10 of them became better and the jaundice disappeared ,1 of them died of renal function fail-ure,2 of them had no marked improvement .Conclusion The major reason of biloma formation may be multiple interventional therapy,and the prognosis of biloma is good .