肝动脉胆道瘘8例报告

Hepatic Arteriobiliary Fistula:the Clinical Data of 8 Patients

[目的]通过对肝动脉胆道瘘病例临床观察分析,探讨其发生原因、临床表现及防治措施。[方法]收集原中山医科大学附属第一医院1982-2001年肝动脉插管化疗和皮下灌注器进行肝动脉栓塞化疗肝癌308例,对发生肝动脉胆道瘘者进行临床分析。[结果]本组有8例出现肝动脉胆道瘘,发生率为2.6％,出现时间在2个月至2年半的长期化疗栓塞过程中。临床表现以腹痛为主,偶然出现呕吐、发热等。[结论]长时间肝动脉插管化疗、栓塞,肝动脉胆管壁缺血,高浓度化疗、栓塞药物反复刺激,以及肿瘤坏死等因素影响,可导致肝动脉胆道瘘的发生。

[ Objective J To analyze the causes, clinical manifestation and therapy for hepatic arteriobiliary fistula(HABF). [Method] We collected the clinical data of 8 patients who suffered from hepatic arteriobiliary fistula in 308 cases of hepatocellular carcinoma treated with hepatic artery emboliza-tion and chemotherapy by subcutaneous infusing apparatus during 1982-2001. [Result] The incidence of hepatic arteriobiliary fistula was 2. 6% (8/308) . The range of occurring time was 2 to 30 months after the first embolization and chemotherapy. The manifestation of this complication includes abdominal pain, vomiting and fever etc. [Conclusion] HABF is a common complication after embolization of hepatocellular carcinoma through subcutaneous infusing tube, and may be the result of long-term artery embolization, irritation of chemotherapeutic agents and tumor necrosis after therapy.