- 期刊
Biloma Following Transcatheter Arterial Chemoembolization with Microspheres: A Case Report
經肝動脈化學栓塞使用Microspheres併發膽汁瘤－病例報告
摘要
We report a case of intrahepatic biloma following transcatheter arterial chemoembolization(TACE)with microspheres in a 44-year-old male patient. He was diagnosed with hepatocellular carcinoma with satellite nodules and intrahepatic duct invasion in August 2004. TACE was performed with a mixture of lipiodol, epirubicin hydrochloride, and mitomycin followed by microspheres as devascularizing material. Local external irradiation was performed on the area of intrahepatic duct invasion after the first TACE. Owing to local tumor progression and growth of new tumor nodules, a series of TACEs were performed. However, fever and diarrhea developed 2 weeks after the third TACE. Biloma with infection was diagnosed and was then treated successfully with percutaneous drainage and antibiotics. Embolization using microspheres at the proximal right hepatic artery was considered to have been the jeopardizing etiologic factor of biloma formation.
並列摘要
我們報告一位44歲男性肝癌患者，使用microsPheres施行經肝動脈化學栓塞療扶後發生膽汁瘤。他是在2004年8月被診斷出肝癌並且合併肝內膽管侵犯。患者隨即接受經肝動脈化學栓塞治療，使用liPiodol混合epirubicin hydrochloride及mitomycin並以microspheres 作為血管阻斷藥物。在第一次肝動脈栓塞治療之後加上局部放射線治療肝內膽管侵犯部分。山於追蹤發現長出新腫瘤，患者後來又接受一系列肝動脈栓塞治療。在第三次栓塞治療後二星期出現發燒及腹瀉的情形，診斷為膽汁瘤合併感染，隨即以抗生素及引流治療。我們認為使用microspheres栓塞近端右肝動脈是誘發導致膽汁瘤的危險原因。
延伸閱讀
- Tsai, Y. J., Lo, H. W., Chen, M. C., Chen, S. R., Tsai, C. Y., Chen, P. H., Juan, C. C., & Tseng, C. S. (2008). 肝動脈灌注化學療法治療瀰漫型肝癌病人合併門靜脈栓塞之研究. 臺灣消化醫學雜誌, 25(1), 6-11. https://doi.org/10.6557/GJT.200803_25(1).0002
- Lim, P. P., Koay, L. B., Lin, C. Y., Sheu, M. J., Kuo, H. T., Sun, C. S., Feng, I. C., Lin, Y. M., & Hsieh, P. H. (2015). 巨大肝細胞癌經載藥微球肝動脈化療栓塞術後併發化膿性肝膿瘍：病例報告以及文獻回顧. 內科學誌, 26(2), 115-119. https://doi.org/10.6314/JIMT.2015.26(2).07
- Yew, D. S. Y., Lin, K. H., Shih, B. F., Wu, M. Z., Tsao, C. H., & Chen, H. W. (2022). 用Tc-99m Mebrofenin肝膽閃爍造影診斷繼發於肝細胞癌治療的支氣管膽道廔管：病例報告和文獻回顧. 核子醫學暨分子影像雜誌, 35(2), 66-71. https://doi.org/10.6332/ANMMI.202206_35(2).0003
- Lin, C. Y., Bora, D., Tai, W. C., Lin, T. L., Li, W. F., Liu, C. Y., Chen, C. L., & Wang, C. C. (2011). 經內視鏡逆行性膽胰管攝影術後合併十二指腸憩室出血：病例報告和文獻回顧. 中華民國急救加護醫學會雜誌, 22(4), 164-169. https://doi.org/10.30018/JECCM.201112.0003
- Chen, C. C., Huang, S. C., Huang, S. C., & Shieh, C. S. (1994). 膽管囊腫接受Roux-en-Y吻合術後併發逆行性腸套疊－一病例報告. Acta Paediatrica Sinica, 35(6), 546-551. https://doi.org/10.7097/APS.199412.0546