| Objective:To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization(TAE) for treatment of symptomatic polycystic liver disease(PLD),to provide new treatment for clinical treatment.Methods:We analyzed retrospectively the clinicai data of 19 patients( 18 patients with polycystic kidney) with symptomatic polycystic liver disease in our hospitai from July 2009 to June 2014, and underwent super-selective TAE treatment in the operating room. Clinical symptoms more performance for abdominal distension(17 cases), abdominal pain(13 cases), door appetite(15 cases), dyspnea(7 cases), liver enlargement(19 cases), etc. All patients underwent contrast enhanced computed tomography CT(Including scan and enhanced scan arterial and portal venous phase) scan of the liver before TAE and 12 months after TAE, and record intrahepatic cyst volume size, compare the preoperative and postoperative cyst volume change in December, Postoperative changes of liver function(ALT、AST、TBIL、ALB) and adverse reactions.using the t test. At the same time every 3 months follow-up of patients with postoperative clinical symptoms improve the situation and physical status score(using the Karnofsky score method).Results:Technical success rate was 100%, postoperative appear different degree of adverse reactions after embolization(including fever, liver pain, etc.) in 1-5 days,giving better after symptomatic treatment. Preoperative cyst volume was 3120-8935 cm3,the average was 5805 ± 1725 cm3. 12 months later, cyst volume was 2019-5925 cm3, the average was 3778 ± 1252 cm3,using the t test,t=13.771,P<0.001.The difference was statistically significant. Intrahepatic cyst volume to reduce the rate of 24.3%- 60.4%, the average(35.5 + 8.1) %. Patients with postoperative 1 week to detect ALT、AST、TBIL、ALB levels, there were no significant difference compared with before operation. All patients were followed up for at least 1 year, most of the patients symptoms had no significant improvement within 3 months after TAE. In the process of 6 to 12 months follow-up, 19 cases(13 cases at the time of 6 months follow-up, 19 cases at the time of 12 months follow- up) in patients with symptoms(indigestion, abdominal distension, discomfort, after full bilge, difficulty breathing, indigestion, etc.) have improved significantly, And in the subsequent follow-up symptoms continue to ease. All patients with preoperative physical status score below 80 points,12 months after all patients physical status score of 90-100 points and the quality of life than before treatment significantly improved. Conclusions:1.With the development of minimally invasive treatment of polycystic liver gradually from the traditional surgery to minimally invasive surgery. Especially it as a treatment for symptomatic PLD is a new attempt, With safe, effective and reliable curative effect, fewer complications, etc. It can obviously reduce the postoperative recurrence rate and patient pain, improve curative effect. Therefore,it has important value of clinical applications.2.This topic mainly confirmed polycystic liver blood supply arteries to hepatic artery branches. The faster and more cyst of the recent growth of blood supply, the more abundant.3.TAE treatment mainly by blocking capsule wall blood supply arteries, Make the thecal sac ischemic necrosis, cystic fluid absorption, cyst gradually shrink or disappear.4.TAE is a kind of effective treatment of polycystic liver, can alleviate the symptoms, make cyst shrink or disappear a reliable treatment. |
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