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中华肝脏外科手术学电子杂志 ›› 2016, Vol. 05 ›› Issue (01) : 47 -50. doi: 10.3877/cma.j.issn.2095-3232.2016.01.012

所属专题: 文献

临床研究

腔内超声造影在肝细胞癌消融术后胆管支气管瘘诊断中的价值
周泽浩1, 黄倩楠1, 许尔蛟1, 郑荣琴1, 李凯1,()   
  1. 1. 510630 广州,中山大学附属第三医院超声科
  • 收稿日期:2015-11-20 出版日期:2016-02-10
  • 通信作者: 李凯
  • 基金资助:
    国家自然科学基金青年科学基金(81301931)

Value of intracavitary contrast-enhanced ultrasound in diagnosis of biliary-bronchial fistula after hepatocellular carcinoma ablation

Zehao Zhou1, Qiannan Huang1, Erjiao Xu1, Rongqin Zheng1, Kai Li1,()   

  1. 1. Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2015-11-20 Published:2016-02-10
  • Corresponding author: Kai Li
  • About author:
    Corresponding author: Li Kai, Email:
引用本文:

周泽浩, 黄倩楠, 许尔蛟, 郑荣琴, 李凯. 腔内超声造影在肝细胞癌消融术后胆管支气管瘘诊断中的价值[J/OL]. 中华肝脏外科手术学电子杂志, 2016, 05(01): 47-50.

Zehao Zhou, Qiannan Huang, Erjiao Xu, Rongqin Zheng, Kai Li. Value of intracavitary contrast-enhanced ultrasound in diagnosis of biliary-bronchial fistula after hepatocellular carcinoma ablation[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2016, 05(01): 47-50.

目的

探讨腔内超声造影在肝细胞癌(肝癌)消融术后胆管支气管瘘诊断中的价值。

方法

回顾性分析2012年2月在中山大学附属第三医院接受诊治的1例肝癌消融术后胆管支气管瘘患者临床资料。患者已签署知情同意书,符合医学伦理学规定。患者男,56岁,2010年9月超声引导下行肝癌射频消融,术后1个月复查提示消融完全,且未见明显肿瘤复发。术后10个月开始出现反复发热并于术后17个月出现咳胆汁痰等症状。经MRI检查发现原消融灶部位胆汁湖形成,遂行胆汁湖穿刺置管,并行透视检查及腔内超声造影检查明确诊断。

结果

腔内超声造影检查发现胆管瘘道通向右侧胸腔。置管引流后患者症状缓解,其后行腔内超声造影复查提示胆管瘘道消失,胆汁湖持续存在,随后行右半肝切除术,治愈出院。

结论

肝癌消融后胆管支气管瘘是一种罕见并发症,腔内超声造影检查可作为其诊断治疗的良好补充手段。

Objective

To evaluate the value of intracavitary contrast-enhanced ultrasound in the diagnosis of biliary-bronchial fistula after hepatocellular carcinoma ablation.

Methods

Clinical data of 1 case with biliary-bronchial fistula after hepatocellular carcinoma ablation in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The informed consent was obtained and the local ethical committee approval had been received. The male patient, aged 56 years, underwent ultrasound-guided hepatocellular carcinoma radiofrequency ablation in September 2010. Examination revealed the tumor was completely ablated and no recurrence was detected 1 month after ablation. Ten months after operation, the patient suffered from recurrent fever and developed coughing up of bile-stained sputum at 17 months after ablation. MRI examination indicated the formation of a bile lake at the ablation site and percutaneous catheter drainage was performed. The diagnosis was confirmed by fluoroscopic and intracavitary contrast-enhanced ultrasound examination.

Results

The biliary fistula tract was found connected to the right chest by intracavitary contrast-enhanced ultrasound examination. After drainage the patients' symptoms were relieved. The biliary fistula tract disappeared when checked by intracavitary contrast-enhanced ultrasound but the bile lake still existed. Right hemihepatectomy was performed subsequently. The patient was cured and discharged.

Conclusions

Biliary-bronchial fistula is a rare complication after hepatocellular carcinoma ablation. Intracavitary contrast-enhanced ultrasound could serve as a useful complementary method for the diagnosis and treatment of biliary-bronchial fistula.

图1 肝癌射频消融术后胆管支气管瘘常规超声及腔内超声造影图
表1 肝癌射频消融术后胆管支气管瘘病例报道情况
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