Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Hepatectomia/métodos , Neoplasias Hepáticas/terapia , Recidiva Local de Neoplasia/terapia , Adulto , Angiografia , Carcinoma Hepatocelular/diagnóstico , Seguimentos , Humanos , Neoplasias Hepáticas/diagnóstico , Masculino , Recidiva Local de Neoplasia/diagnósticoRESUMO
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.
Assuntos
Neoplasias do Sistema Digestório/diagnóstico por imagem , Neoplasias do Sistema Digestório/terapia , Icterícia/etiologia , Radiografia Intervencionista , Adulto , Idoso , Antineoplásicos/uso terapêutico , Quimioembolização Terapêutica , Neoplasias do Sistema Digestório/complicações , Drenagem , Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/terapia , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/terapia , Estudos Retrospectivos , Stents , Análise de Sobrevida , Resultado do TratamentoRESUMO
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.
Assuntos
Colestase/cirurgia , Drenagem/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Radiografia Intervencionista/métodos , Ultrassonografia de Intervenção/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Colestase/diagnóstico por imagem , Colestase/etiologia , Neoplasias do Sistema Digestório/complicações , Drenagem/efeitos adversos , Drenagem/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/mortalidade , Punções , Radiografia Intervencionista/efeitos adversos , Radiografia Intervencionista/mortalidade , Resultado do Tratamento , Ultrassonografia de Intervenção/efeitos adversos , Ultrassonografia de Intervenção/mortalidadeRESUMO
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.
