Embolization of hepatic arterioportal shunt with ethanol-soaked gelatin sponge.

Abstract

The objective of this study is to investigate the effect of ethanol-soaked gelatin sponge (ESG) in the treatment of hepatic arterioportal shunt (APS). Hepatocellular carcinoma (HCC) patients with APS were divided into experimental group (Group E) and control group (Group C). Patients in Group E were treated with ESG for APS embolization, whereas patients in Group C were treated with polyvinyl alcohol particles for APS embolization, with other treatment unchanged. APS and the Eastern Cooperative Oncology Group (ECOG) physical status scores of patients before and after the first treatment and further consultation in the 6th week and the survival rate in follow-up visit were recorded. The changes of liver function during treatment were monitored. Before the first treatment, there was no statistical significant difference in APS between two groups. After that, APS in Groups E (P = 2.49 × 10-7) and C (P = 2.10 × 10-4) was improved. In further consultation, APS in Groups E (P = 2.73 × 10-13) and C (P = 2.90 × 10-8) was further improved after examinations and corresponding treatment. After the first treatment and further consultation, APS score was lower in Group E than in Group C, and there were still five patients whose APS score was 2 in Group C. Quality of life in two groups was effectively controlled without getting worse and the ECOG score reduced. Liver function in the two groups did not worsen with the use of liver protective drugs. No deaths occurred in Group E, whereas two patients died in Group C during treatment and follow-up visit. The results show that ESG can effectively reduce APS score and improve the survival rate of HCC patients.