Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Hepatectomy/methods , Liver Neoplasms/therapy , Neoplasm Recurrence, Local/therapy , Adult , Angiography , Carcinoma, Hepatocellular/diagnosis , Follow-Up Studies , Humans , Liver Neoplasms/diagnosis , Male , Neoplasm Recurrence, Local/diagnosisABSTRACT
We assessed the role of interventional radiological procedures used in the treatment of patients with hepatopancreatobiliary cancer complicated by obstructive jaundice. Between 1990 and 2000, 71 patients underwent percutaneous transhepatic biliary drainage (PTBD): external drainage--18 (group A); external-internal drainage or stenting (group B), and external-internal drainage or stenting plus chemoinfusion or chemoembolization of the hepatic artery--15 (group C). Mean survival (M(SD) calculated for patients who died was 2.1(0.5 mo for group A; (pb,c(0.01), 7.9(6.7 mo (group B), and 16.6(14.8 mo for group C (NS with B). The actual one-year survival was 10, 25, and 45%, respectively. External-internal PTBD and stenting are safe effective palliative procedures for patients with malignant obstructive jaundice. Survival in patients with hepatopancreatobiliary cancer doubled after chemoinfusion or chemoembolization, without grave complications or lethality.
Subject(s)
Digestive System Neoplasms/diagnostic imaging , Digestive System Neoplasms/therapy , Jaundice/etiology , Radiography, Interventional , Adult , Aged , Antineoplastic Agents/therapeutic use , Chemoembolization, Therapeutic , Digestive System Neoplasms/complications , Drainage , Duodenal Neoplasms/diagnostic imaging , Duodenal Neoplasms/therapy , Female , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/therapy , Male , Middle Aged , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/therapy , Retrospective Studies , Stents , Survival Analysis , Treatment OutcomeABSTRACT
In 1990-2000, percutaneous transhepatic cholangiodrainage was performed in 89 patients with obstructive jaundice of tumoral etiology: Groups A (n = 21) under roentgenoscopic guidance and Group B (n = 68) under ultrasound guidance (USG). The efficiency and safety of puncture of the biliary tract were comparatively evaluated in these groups. The technical success of the procedure was achieved in 81.0% of Group A patients and in 98.5% of Group B ones. USG decreased radiation load on the patient and medical staff by three times and the number of needle passes by two times. External-and-internal cholangiodrainages under USG and roentgenoscopy were performed in 55.2 and 23.8%, respectively. The incidence of complications and mortality were 5.9 and 1.5% in Group B and versus 17.6% and 4.8% in Group A. It is concluded that transhepatic cholangiodrainage under USG has some advantage over puncture of the biliary tract under roentgenoscopy.
Subject(s)
Cholestasis/surgery , Drainage/methods , Minimally Invasive Surgical Procedures/methods , Radiography, Interventional/methods , Ultrasonography, Interventional/methods , Adult , Aged , Aged, 80 and over , Cholestasis/diagnostic imaging , Cholestasis/etiology , Digestive System Neoplasms/complications , Drainage/adverse effects , Drainage/mortality , Female , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/mortality , Punctures , Radiography, Interventional/adverse effects , Radiography, Interventional/mortality , Treatment Outcome , Ultrasonography, Interventional/adverse effects , Ultrasonography, Interventional/mortalityABSTRACT
The article describes the method and results of the puncture sclerotherapy of nonparasitic liver cysts in 30 patients. Cooled to -28 degrees C 96% ethyl alcohol was used as a sclerosing agent. The total destructive effect of the agent was obtained due to the combination of its chemical and physical (temperature) factors. Complete recovery was obtained in 86.6% of the patients. The puncture sclerotherapy can be used as a medical alternative for nonparasitic liver cysts.
