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目的研究肝脏肿瘤经动脉化疗栓塞(TACE)后胆汁瘤形成的原因及处理方法。方法11例肝脏肿瘤经动脉化疗栓塞后胆汁瘤形成的患者,记录患者胆汁瘤形成前有无黄疸及处理方法,胆汁瘤形成前TACE次数,碘油栓塞后沉积表现,胆汁瘤形成时间,穿刺引流及预后。结果胆管癌患者5例,肝癌4例,结肠癌肝转移2例。胆汁瘤形成前有黄疸者7例,7例曾有经皮穿肝胆道引流术(PTCD)及胆道支架植入史。TACE次数平均值为3次(1~5次),碘油沉积散在淤滞于肝动脉。胆汁瘤形成于末次TACE后2~4周,7例穿刺引流证实胆汁瘤与胆道相通。7例同时接受PTCD者胆汁瘤愈合,3例未接受PTCD者,胆汁瘤引流管无法拔除,另1例死于引流后1月肾功能衰竭。结论胆汁瘤形成与TACE中碘油栓塞、淤滞有关。胆汁瘤引流非常重要,部分患者PTCD可降低胆道压力加速胆汁瘤愈合。
Objective To study the cause of formation of bile tumor after transcatheter arterial chemoembolization (TACE) in liver tumors and its treatment. Methods 11 patients with hepatic tumors who underwent transcatheter arterial chemoembolization (BCC) of the gallbladder tumor were enrolled in this study. The patients with or without jaundice and the method of treatment were recorded before the formation of bile tumor. The number of TACE before the formation of bile duct, the deposition after lipiodol embolization, the time of biliary tumor formation, And prognosis. Results 5 cases of cholangiocarcinoma, 4 cases of liver cancer, 2 cases of colon cancer liver metastases. 7 cases had jaundice before bile tumor formation, and 7 cases had percutaneous transhepatic biliary drainage (PTCD) and biliary stent implantation history. The average number of TACE was 3 times (1 ~ 5 times), lipiodol scattered scattered in the hepatic artery. Bile tumors formed in the last 2 to 4 weeks after TACE, 7 cases of puncture drainage confirmed bile duct and biliary communication. Seven patients with PTCD who underwent simultaneous bile duct heal, three patients who did not receive PTCD, the bile duct drainage tube could not be removed, and the other one died of renal failure in January after drainage. Conclusions The formation of bile tumor is related to the embolization and stasis of lipiodol in TACE. Bile duct drainage is very important, in some patients PTCD can reduce the biliary pressure to accelerate the healing of bile tumors.