AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral ...AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.展开更多
Biloma is an encapsulated bile collection outside the biliary tree due to a bile leak. It is occasionally found following traumatic liver injury or iatrogenic injury to the biliary tract, induced either during an endo...Biloma is an encapsulated bile collection outside the biliary tree due to a bile leak. It is occasionally found following traumatic liver injury or iatrogenic injury to the biliary tract, induced either during an endoscopic or surgical procedure. It is a rare complication of transcatheter arterial embolization (TAE). Although biloma can be shrunk by appropriate aspiration or drainage in majority of cases,we report a case of intrahepatic biloma following repeated TAE for hepatocellular carcinoma (HCC) and complicated by infection and intrahepatic stones. This particular constellation of problems has not been reported before and the intrahepatic stones need to be removed by percutaneous procedure.展开更多
OBJECTIVE Vertebral metastases are a common manifestation in patients with advanced cancer and treatment is often ineffective. This study was conducted to explore the efficacy of treating vertebral metastases by percu...OBJECTIVE Vertebral metastases are a common manifestation in patients with advanced cancer and treatment is often ineffective. This study was conducted to explore the efficacy of treating vertebral metastases by percutaneous vertebroplasty (PVP) combined with interventional chemotherapy. METHODS Seventy-five patients with vertebral metastases (42 men, 33 women; ages 31-76 years) were divided into 2 groups: 39 cases were treated by PVP combined with chemotherapy (VPCC group), and 36 cases were treated by PVP alone (VP group). All procedures were guided by computed tomography (CT) scanning. The results and complications were evaluated by a questionnaire regarding pain and routine follow-up. RESULTS The response rate was significantly higher in the VPCC group than in the VP group (93.0% vs 74.4%, P〈0.05); total response rates for the VPCC and VP groups were 25.6% and 10.3% respectively. A common complication related to VPCC was transient aggravating pain. CONCLUSION PVP may ameliorate pain, and consolidate the vertebrae of patients with vertebral metastases. Its short-term effect may be enhanced by adding drugs into the bone cement.展开更多
The small bowel metastases from head and neck regions are extremely rare. The diagnosis and treatment of such kind of small bowel metastases remain unclear. This paper reports on a 53-year-old case with small intestin...The small bowel metastases from head and neck regions are extremely rare. The diagnosis and treatment of such kind of small bowel metastases remain unclear. This paper reports on a 53-year-old case with small intestine perforation caused by metastasis from squamous cell carcinoma of scalp. After surgical treatment, the patient had a relatively better survival. This paper shares the clinical experience we have learned from managing this patient in hope that it will help other medical professionals in oncology to recognize the disease.展开更多
文摘AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.
文摘Biloma is an encapsulated bile collection outside the biliary tree due to a bile leak. It is occasionally found following traumatic liver injury or iatrogenic injury to the biliary tract, induced either during an endoscopic or surgical procedure. It is a rare complication of transcatheter arterial embolization (TAE). Although biloma can be shrunk by appropriate aspiration or drainage in majority of cases,we report a case of intrahepatic biloma following repeated TAE for hepatocellular carcinoma (HCC) and complicated by infection and intrahepatic stones. This particular constellation of problems has not been reported before and the intrahepatic stones need to be removed by percutaneous procedure.
文摘OBJECTIVE Vertebral metastases are a common manifestation in patients with advanced cancer and treatment is often ineffective. This study was conducted to explore the efficacy of treating vertebral metastases by percutaneous vertebroplasty (PVP) combined with interventional chemotherapy. METHODS Seventy-five patients with vertebral metastases (42 men, 33 women; ages 31-76 years) were divided into 2 groups: 39 cases were treated by PVP combined with chemotherapy (VPCC group), and 36 cases were treated by PVP alone (VP group). All procedures were guided by computed tomography (CT) scanning. The results and complications were evaluated by a questionnaire regarding pain and routine follow-up. RESULTS The response rate was significantly higher in the VPCC group than in the VP group (93.0% vs 74.4%, P〈0.05); total response rates for the VPCC and VP groups were 25.6% and 10.3% respectively. A common complication related to VPCC was transient aggravating pain. CONCLUSION PVP may ameliorate pain, and consolidate the vertebrae of patients with vertebral metastases. Its short-term effect may be enhanced by adding drugs into the bone cement.
文摘The small bowel metastases from head and neck regions are extremely rare. The diagnosis and treatment of such kind of small bowel metastases remain unclear. This paper reports on a 53-year-old case with small intestine perforation caused by metastasis from squamous cell carcinoma of scalp. After surgical treatment, the patient had a relatively better survival. This paper shares the clinical experience we have learned from managing this patient in hope that it will help other medical professionals in oncology to recognize the disease.