Diagnosis and treatment of severe complications after transcatheter arterial chemoembolization of hepatocellular carcinoma
10.3877/cma.j.issn.2095-3232.2014.02.010
- VernacularTitle:肝细胞癌经导管动脉化疗栓塞术后严重并发症患者的诊治体会
- Author:
Kunpeng HU
1
;
Zhaofeng TANG
;
Zhicheng YAO
;
Jizong LIN
;
Pinzhu HUANG
;
Meihai DENG
;
Ruiyun XU
;
Bo LIU
Author Information
1. 中山大学附属第三医院岭南医院普通外科
- Keywords:
Carcinoma,hepatocellular;
Radiology,interventional;
Postoperative complications;
Liver abscess;
Cholangitis;
Paracentesis;
Drainage
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2014;(2):104-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the diagnosis and treatment of severe complications after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods Clinical data of 15 patients with severe complications after TACE of HCC in Department of General Surgery, Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University from June 2011 to May 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. There were 12 males and 3 females with age ranging from 40 to 78 years old and the median age of 55 years old. Results Manifestations of cholangitis such as abdominal pain, fever, rising white blood cell etc. were observed in all the patients. According to the clinical manifestations, history of receiving TACE and imaging examinations, 10 cases were diagnosed with biloma after TACE of HCC, 4 cases with liver abscess and 1 case with ischemic cholangitis. All the patients received basic treatments of anti-infection, cholagogue and liver protection. Ten cases with biloma were cured after receiving ultrasound-guided percutaneous transcatheter drainage of biloma, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD). Four cases with liver abscess were cured after receiving ultrasound-guided percutaneous transcatheter drainage of liver abscess, local douche with antibiotics. One case with ischemic cholangitis received drainage of 3 catheters of PTCD and the serum bilirubin went down from 500μmol/L to 300μmol/L, but gave up treatment ifnally because of complicating severe biliary infection and gastrointestinal hemorrhage. Conclusions The diagnosis of severe complications after TACE of HCC is mainly based on the clinical manifestations, history of receiving TACE and imaging examinations. The therapies include basic treatments of anti-infection, cholagogue and liver protection etc., and symptomatic treatments of ultrasound-guided percutaneous drainage, PTCD, ENBD, etc.
