Avtor/Urednik     Skalicky, Marjan; Menih, Marija
Naslov     Portokavalni obvod in hepatocelularni karcinom
Prevedeni naslov     Portacaval shunt and hepatocellular carcinoma
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 68, št. 7-8
Leto izdaje     1999
Obseg     str. 421-4
Jezik     slo
Abstrakt     Background. 71-year-old male patient was admited to hospital, complaining of weight loss and upper abdominal pain. We diagnosed a hepatocellular carcinoma. 18 years after establishment of non-selective portacaval shunt, there was no development of postoperative portosystemic encephalophaty, altough it is described in literature at high percentage. Methods. The flow velocities through the portacaval shunt and through the hepatic artery were measured by Doppler ultrasonography. Celiacography and mesentericography were performed. As the hepatocelular carcinoma was unresectable, the patient was reffered for chemoembolisation. Conclusions. Long survival and/or the absence of postoperative portosystemic encelopathy are possible inthe cases with favourable anatomic variant of the right hepatic artery, which allows chemoembolisation in spite of portacaval shunt. Therefore, portosystemic shunt could be associated with the development of hepatocellular carcinoma.
Izvleček     Izhodišča. 71-letni bolnik je bil sprejet v bolnišnico zaradi izgube telesne teže in bolečin vzgornjem delu trebuha. Ugotovili smo hepatocelularni karcinom. Pri bolniku z neselektivnim portokavalnim obvodom se v 18 letih ni razvila pooperativna portosistemska encefalopatija, čeprav je ta v literaturi opisana v visokem odstotku. Metode. S pomočjo Dopplerjeve UZ preiskavne metode smo izmerili hitrosti pretoka skozi portokavalni obvod in skozi hepatično arterijo. Opravljena je bila celiakografija in mezenterikografija. Ker pri bolniku karcinoma jeter ni bilo mogoče operirati, smo ga zdravili s kemoembolizacijo. Zaključki. Dolgo preživetje in/ali odsotnost pooperativne porto sistemske encefalopatije sta možna ob ugodni anatomski različici izvora desne hepatične arterije. Ta je tudi dovoljevala kemoembolizacijo kljub portokavalnemu obvodu. Portosistemski obvod morda res vpliva na razvoj hepatocelularnega karcinoma.
Deskriptorji     CARCINOMA, HEPATOCELLULAR
PORTACAVAL SHUNT, SURGICAL
ULTRASONOGRAPHY, DOPPLER
BLOOD FLOW VELOCITY
CHEMOEMBOLIZATION, THERAPEUTIC
SURVIVAL ANALYSIS
HEPATIC ARTERY
HEPATIC ENCEPHALOPATHY