肝癌之肝動脈門脈間瘻管栓塞治療－病例報告

The Management of Hepatic Arterio-Portal Shunting in Hepatocellular Carcinoma-A Case Report

郭萬祐(Wan-Yuo Guo) ； 楊建芳(Chien-Fang Yang) ； 蘇友吉(Yeou-Gie Su) ； 田雨生(Yeu-S Tyan) ； 何永仁(Yung-Jen Ho) ； 姜仁惠(Jen-Huey Chiang) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 10卷2期 (1985/06) Pp. 143-146

摘要

肝硬化病人常死於食道靜脈曲張破裂所引起的上腸胃道大量出血。此類病人若合併有肝癌所形成的肝動脈門脈間瘻管，則更易引起門脈壓升高，而增加血管破裂的危險性。以選擇性肝動脈栓塞療法，利用導管經由肝動脈將瘻管以Gelfoam碎片及不銹鋼線圈(coil)阻塞，可以顯著降低門脈壓力，緩解血管破裂危機，延長生命。

並列摘要

Ruptured esophageal varices with massive hematemesis is a common cause of death in cirrhosis associated with hepatoma. Once the arterio-portal shunting develops, the direct transmission of the arterial pressure as well as the increased blood flow ‘to the portal system contributes to the increase of portal pressure. The direction of the flow ifl theportal system is then altered to hepatofugal condition and causes decreased perfusion of the liver and increases the risk of variceal bleeding. Transcatheter arterial embolization with gelfoam pieces, and coil can occlude the fistula. After embolization, the portal pressure and the risk of esophageal varices bleeding will decrease significantly and, thus, eliminate the need for surgical treatment and prolonged the patient's life.