FIELD: medicine; surgery; oncology.
SUBSTANCE: open surgical and endovascular approaches are combined. Laparotomy is performed, the right gastric artery is bandaged. Through the gastroduodenal artery, a cannula is inserted into the proper hepatic artery to deliver the chemotherapy medicinal product. The endovascular stage is performed using a 2-balloon catheter, after which it is inserted into the femoral vein and is positioned as follows: the upper balloon covers the lumen of the inferior vena cava after the hepatic veins depart; the lower balloon is positioned below the hepatic veins. The lumen of the catheter through which perfusion is carried out is placed at the mouth of the hepatic veins. After positioning the balloon, the aorta is clamped subdiaphragmatically, then the common hepatic artery is clamped before the gastroduodenal artery departs from it. The lower and upper balloons are sequentially inflated on a catheter installed in the inferior vena cava, after which isolated liver chemoperfusion is started.
EFFECT: method allows to reduce the invasiveness of the procedure due to the absence of the need to perform extensive mobilization of the liver and cannulation of the inferior vena cava through laparotomy access, increases efficiency due to the possibility of repeated chemoperfusion.
1 cl, 1 ex
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Authors
Dates
2023-10-11—Published
2022-06-14—Filed