Prevention of variceal rebleeding and treatment of liver carcinoma by consecutive transjugular intrahepatic portosystemic shunt and hepatic artery chemoembolization.

A Nicolini, S Saccheri, A Lovaria, A Maggi, M Cazzaniga, A Panzeri, F Salerno
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Abstract

Variceal bleeding and hepatocellular carcinoma are two severe complications of cirrhosis. One of our patients who bled from oesophageal varices was found to have a malignant hepatic nodule. As the patient refused liver transplantation, a transjugular intrahepatic portosystemic stent was carried out for portal hypertension, and transcatheter arterial chemoembolization for cancer. Both procedures were successful and one year later liver function has not deteriorated. This case shows that intrahepatic stent placement and selective arterial chemoembolization can be safely performed in cirrhotic patients with a solitary hepatocarcinoma nodule and a good liver function reserve.

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连续经颈静脉肝内门静脉分流术及肝动脉化疗栓塞治疗肝癌预防静脉曲张再出血。
静脉曲张出血和肝细胞癌是肝硬化的两种严重并发症。我们的一名患者因食道静脉曲张出血,被发现有一个恶性肝结节。由于患者拒绝肝移植,对门静脉高压症行经颈静脉肝内门静脉系统支架治疗,对癌行经导管动脉化疗栓塞治疗。两种手术都很成功,一年后肝功能没有恶化。本病例表明,肝内支架置入术和选择性动脉化疗栓塞可以安全地用于肝硬化单发肝癌结节和肝功能储备良好的患者。
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