Korean Journal of Gastrointestinal Endoscopy 2000;20(3): 183-190.
원발성 간암 환자에서 간동맥 색전술 시행 후 위십이지장 병변의 발생과 관련된 인자 ( Factors Associated with the Development of Gastroduodenal Lesions after Transcatheter Arterial Embolization in a Hepatocellular Carcinoma )
최정일(Jung Il Choi),하승수(Seung Su Ha),전성우(Seong Woo Jeon),조재현(Jae Hyun Cho),탁원영(Won Young Tak),권영오(Young Oh Kweon),김성국(Sung Kook Kim),최용환(Yong Hwan Choi),정준모(Joon Mo Chung),염헌규(Heon Kyu Reom),김용주(Yong Joo Kim)
Abstract
Background/Aims: Gastroduodenal lesions such as erosions and ulcers are less infrequent complications after transcatheter arterial embolization (TAE) procedures. This study was conducted to clarify the incidence and associated factors of post-TAE gastroduodenal lesions. Methods: Cases involving 142 patients with unresectable hepatocellular carcinoma (HCC) who underwent TAE during 70 months were retrospectively analyzed. Endoscopic examinations were performed before and after TAE. Patients were classified into two groups depending upon whether gastroduodenal lesions developed or not. Results: New gastroduodenal lesions developed in 32 of 142 patients (22.5%) within 3 months of TAE. Of these, 14 patients (9.9%) developed upper gastrointestinal bleeding. There were no significant differences in clinical and biochemical characteristics between the two groups (p＞0.05). There was also no significant difference in catheter selection level, tumor type, number of TAE, use of gelform between the two groups (p＞0.05). However, the cases involving large tumor size (＞8 cm) and angiographical abnormalities of hepatic arteries including atypical branching, vascular tortuosity, spasms or intimal dissection during the procedure, infusion of embolizing materials adjacent to vessels supplying the stomach or duodenum, had more post-TAE gastroduodenal lesions. These two factors were found to significantly affect the development of post-TAE gastroduodenal lesions by multivariate analysis (p＜0.05). Conclusions: The major factors associated with the development of post-TAE gastroduodenal lesions are large tumor sizes and angiographical abnormalities of hepatic arteries. Upper gastrointestinal endoscopy should be performed as follow-up examinations in these patients.
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