放射微粒栓塞相关胆道后遗症
68 y/o female； Metastatic breast cancer
一项研究显示327例病人，共569次放射微粒栓塞，术后影像学发现10%的病人出现胆道并发症【3】。 胆管狭窄 2.4% 胆管坏死 3.9% 胆汁瘤 1% 胆囊炎 1.8%（0.6%需要外科手术） Justin 等人报告放射微粒栓塞前防止胆囊动脉栓塞。N=46例病人，35例应用明胶海绵块，11例应用弹簧栓子，7%的病人有右上腹疼痛，2%(N=1）病例需要进行胆囊切除术。近端胆囊动脉栓塞是安全的。
对于多病灶肝癌，放射微粒的灌注不能避开胆囊动脉的情况下可考虑灌注前阻塞胆囊动脉，所谓prophylactic embolization of the Cystic artery【4】。
 病人在年老，体弱，腹水和凝血功能障碍的病人需要谨慎应用。 放射学栓塞导致肝脏疾病 Radioembolization-induced liver disease，RILD
胆红素增加 Bilirubin increase
碱性磷酸酶增加 Alkaline phosphatase increase
无疾病进展 No progressive disease
放射性栓塞是安全和有效的，但是我们能够做的更好 Radioembolization is safe and effective, but we can do better!
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