肝动脉栓塞术后的肝内外胆道损毁性病变

目的 探讨经导管肝动态栓塞术后对胆道损伤的病因、治疗及预防。方法 总结５例因肝动脉栓塞引起的胆道损伤患者,其中４例为肝血管瘤经导管动脉栓塞术后,１例为手术时结扎肝动脉注射ＴＨ胶后。动物实验观察向大鼠肝动脉内注射乙醇复制血管栓塞剂对肝脏的损伤。结果 ５例患者均有胆道毁坏性病变,甚至造成胆汁性肝硬化,４例进行胆管空肠吻合及胆道支撑。实验结果证实肝动脉注射血管硬化剂无水乙醇后可以引起邻近汇管区肝脏局部坏

Damage to intra- and extrahepatic bile duct after hepatic artery embolization

Objective To study the pathogenesis, treatment and prevention of bile duct damage arising from hepatic artery embolization. Methods Five patients with intra and extrahepatic biliary damage resulting from hepatic artery embolization. Of these patients, 4 were due to hepatic artery embolization for hepatic haemangioma,and 1 was due to injecting TH (methacrylate)compound into the hepatic artery during operation. The hepatic artery was injected with ethanol so as to evaluate liver damage in experimental rats. Results All patients were found to have damage to intra and extrahepatic bile duct at the hilum with biliary hepatocirrhosis; 4 of them received intrahepatic bile duct jejunal anastomosis and bile duct stent. Experiment result revealed obliteration of the bile duct and necrosis of the liver around the portal tract area. ConclusionsArterial embolization of hepatic haemangioma may cause severe biliary damage.