ABSTRACT
Along with the development of interventional appliances and proficiency of operational skills,the interventional diagnosis and treatment via hepatic portal vein system have achieved great progress and improvement.However,in order to further exploit the advantages of interventional diagnosis and treatment, the review of the anatomical structures,normal aberrance of portal venous system were needed.Getting familiar with pathologic condition to discover the new interventional appliances and embolic agents,and then in term of conduct the research on a very tough substancial base in a down-to-earth manner were important.
ABSTRACT
Objective To evaluate the effect of percutaneous transhepatic obliteration(PTO)of gastroesophageal varices in liver cirrhosis.Methods Fifty-six cirrhotic patients suffering from gastroesophageal varices were treated with PTO,including 35 during emergency bleeding,10 after stoppage of hemorrhage and 11 with severe gastroesophageal varices for prevention of bleeding.Results Catheterization and embolization of gastroesophageal varices were successfully performed in all 56 patients(100%).Bleeding stopped after PTO as an emergency treatment was achieved in 35 patients with upper gastrointestinal bleeding.Among them,PTO was performed in 11 patients for preventing variceal hemorrhage,gastroesophageal varices disappeared in 7 and alleviation was obtained evidently in 4.47 patients were followed up for 2-60 months with recurrent bleeding in 5,death in 4 on causes of rebleeding of alimentary tract(1 case),hepatic failure(1 case), hepatocellular carcinoma(2 cases).Conclusion PTO is a safe and effective treatment for gastroesophageal varices in cirrhotic patients and should be recommended extensively.
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Objective To evaluate the clinical value of percutaneous transcatheter selective right portal vein embolization(PVE)in treatment of primary hepatocellular carcinoma.Methods Twelve patients with unresectable hepatocellular carcinoma were treated with right percutaneous transcatbeter PVE under fluoroscopic guidance.Left hepatic lobe volume was measured by CT before and after PVE.Portal vein pressures and changes of liver function were also detected before and after the embolization.Results Right portal vein was embolized successfully in all 12 patients with compensatory hypertrophy of left hepatic lobe.Right hepatic lobe was successfully resected in 3 patients.There were no evidence of hepatic dysfunction and portal hypertension after PVE and also without complication.Conclusions Percutaneous transcathter portal vein branch embolization can induce atrophy of the embolized lobes with compensatory hypertrophy of the remnant liver,providing another operation chance for patients with unresectable hepatocellular carcinoma.
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Objective To evaluate the curative effects of portal vein tumor emboli(PVTE)of hepatocellular carcinoma treated by CT-guided percutaneous ethanol injection(PEI).Methods Absolute ethanol was injected into the tumor embolus of portal vein guided by CT in twenty patients with hepatocellular carcinomas.The procedure was carried out one or two times each week one to three times as a course and one to two courses for a patient.The interval between two courses was one month and the patients were followed up for 6 months-5 years.Results Among the twenty patients,17(85%)were improved in different degrees after the treatment,with disappearence of the tumor emboli in 2(10%)and size stability or even smaller in 15 (75%),and finally no response in 3(15%).Conclusions CT-guided PEI is an effective method for patient with PVTE and proper selection of patient for the procedure is the key to obtain better curative effects.
ABSTRACT
Interventional treatment via portal vein system plays an important role in treating some liver diseases,such as interventional treatment for portal vein tumor thrombus,portal hypertension with liver cirrhosis,portal vein thrombosis and selective portal vein embolization inducing compensatory hypertrophy of the remnant liver.The author introduces the routes,methods and efficacies of the interventional treatment via portal vein.