ABSTRACT
Objective To investigate the changes of splenic and portal venous pressure after partial splenic embolization (PSE),and to discuss its influence factors.Methods PSE was carried out in 14 patients with portal hypertension complicated by hypersplenism.Before and after PSE,the splenic and portal vein pressure was determined by direct manometry method.The post-operative venous pressure was compared with pre-operative one.Contrast-enhanced CT scan was performed 1-2 months after the treatment.Results After PSE,the splenic venous pressure was decreased obviously,a reduction of more than 2 cmH2O in portal venous pressure was observed in 7 patients.Post-operative reexamination with contrast-enhanced CT scan showed that varying degrees of improvement of esophageal and gastric varices could be observed in most patients.Conclusion PSE can effectively decrease the splenic venous pressure,and there are a lot of factors that may influence the short-term reduction in portal vein pressure.
ABSTRACT
Objective To investigate the feasibility,safety and effectiveness of percutaneous biliary stenting combined with brachytherapy in treating unresectable Klatskin's tumor,and to discuss the effect of this combination treatment on jaundice recurrence and survival.Methods The clinical data of 21 patients with unresectable Klatskin's tumor (combination group),who were admitted to Department of Interventional Oncology,Shanghai Renji Hospital during the period from February 2014 to December 2015 to receive percutaneous biliary stenting combined with brachytherapy,were retrospectively analyzed;and other 28 patients,who were admitted to hospital to receive pure biliary drainage or bare metal stent implantation during the same period,were collected and used as the control group.The success rate of operation,the effect of reducing jaundice and postoperative complication rate were calculated,and the differences in survival time and jaundice recurrence time were compared between the two groups.Results A total of 32 bare metal stent sand 580 125I seeds were implanted in the 21 patients of the combination group,the success rate of operation was 100％,and the effective rate of treatment was 85.7％.The early postoperative complication rate was 9.5％,and no procedure-related death occurred.The median jaundice recurrence time in the combination group was 344 days,while it was 193 days in the control group (P=0.035).The median survival time in the combination group was 387 days,which was strikingly longer than 256 days in the control group (P=0.022).Conclusion For the treatment of unresectable Klatskin's tumor,percutaneous biliary stentingcombined with brachytherapy,used as a palliative therapeutic regimen,is safe,effective and feasible,it can delay the recurrence of jaundice and prolong the survival time.(J Intervent Radiol,2017,26:243-248)