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Severe biliary complications after hepatic artery embolization
Xiao-Qiang Huang1, Zhi-Qiang Huang, Wei-Dong Duan
1Department of Hepatobiliary Surgery, General Hospital of PLA, 28 Fuxing Road, Beijing 100853,China. huangxq@ht.rol.cn.net
Aim:
To study the mechanism and treatment of severe biliary complications arising from hepatic artery embolization(HAE).
Methods:
Of seven cases of intra- and extrahepatic biliary damage resulting from hepatic artery embolization reported since 1987, 6 patients suffered from hepatic haemangioma, the other case was due to injection of TH compound into the hepatic artery during operation. The hepatic artery was injected with ethanol so as to evaluate the liver damage in experimental rats.
Results:
All the cases were found to have destructive damage of intra- and extrahepatic bile duct at the hilum with biliary hepatocirrhosis. Experimental results revealed necrosis of the liver parenchyma, especially around the portal tract and obliteration of intrahepatic bile duct.
Conclusions:
To prevent the severe biliary complications of HAE, the use of HAE for hepatic haemangioma which was widely practiced in China, should be re-evaluated. Hepatic arterial embolization of hepatic haemangioma may resulte in severe destructive biliary damages and its indiscriminate use should be prohibited.