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目的探讨肝动脉化疗栓塞术(TACE)后胆汁瘤形成的临床特点。方法行TACE治疗肝癌患者302例(755例次),术后出现胆汁瘤8例(2.65%)。回顾性分析胆汁瘤患者的临床资料。结果 8例胆汁瘤患者中,TACE术前肝功能Child-Pugh分级A级6例,无肝硬化背景5例,转移性肝癌4例,预防性栓塞3例,未超选择性栓塞3例,碘油剂量<5ml 4例,TACE>1次4例。发生胆汁瘤后,行内科保守治疗4例,经保肝、退黄治疗后胆汁瘤未进一步进展;行穿刺引流4例,其中3例穿刺引流后胆汁瘤愈合,1例进展为胆源性肝脓肿,因感染、严重多脏器功能衰竭死亡。结论TACE后胆汁瘤形成较少见,但应加强对胆汁瘤的认识,采取积极治疗措施。
Objective To investigate the clinical features of bile tumor after transcatheter arterial chemoembolization (TACE). Methods TACE treatment of patients with liver cancer in 302 cases (755 times), postoperative bile tumor in 8 cases (2.65%). Retrospective analysis of clinical data of patients with bile tumors. Results Among the 8 patients with Bile Tumors, Child-Pugh grade A was classified as Grade A in 6 cases before TACE, in 5 cases without cirrhosis, in 4 cases with metastatic liver cancer, 3 cases with prophylactic embolization, 3 cases without superselective embolization, Oil dose <5ml in 4 cases, TACE> 1 in 4 cases. Bile tumors occurred after the line of medical conservative treatment in 4 cases, the liver, yellow treatment of bile tumors did not make further progress; line puncture and drainage in 4 cases, of which 3 cases after puncture and drainage bile tumor healed, 1 case progressed to gallbladder liver Abscess, due to infection, severe multiple organ failure. Conclusions The formation of bile tumor after TACE is rare, but the understanding of bile tumor should be strengthened and active treatment should be taken.