经皮肝门脉导管药盒系统植入术

目的：研究经皮肝门脉导管药盒系统（ＰＣＳ）植入术治疗少血性肝转移癌的可行性。材料与方法：对８例不能手术的肝转移瘤患者和２例原发性肝癌肝动脉化疗栓塞术后肝动脉闭塞的患者，行经皮肝穿门脉，沿导丝送入留置管，导管留置于肠系膜上静脉或脾静脉内，药盒植入右上腹壁皮下。术后定期用５－氟尿嘧啶、阿霉素、卡铂经药盒导管系统内滴注或推注化疗。结果：所有患者门脉ＰＣＳ植入术均成功，未见手术并发症。术后随访无门脉血栓形成，２例术后留置管移位脱入腹腔。术后定期行Ｂ超或ＣＴ复查，显示５例肝转移瘤明显缩小，２例无变化，２例肿瘤增大，１例术后１２个月死亡。结论：作者认为经皮肝穿门脉导管药盒系统植入术是可行的，其创伤小、安全、操作技术简单，为少血性肝转移癌及原发型肝癌经门脉内的化疗灌注提供了一种有效的途径。

Percutaneous transhepatic portal vein port catheter system implantation

Purpose: To evaluate the clinical efficacy of percutaneous transhepatic portal vein (PV) port catheter system (PCS) implantation in the treatment of liver carcinoma. Materials and methods: This new interventional technique was used for intra portal chemotherapy in hepatic hypovascular metastases (8 cases) and hepatocellular carcinoma (2 cases) with hepatic artery occlusion after transcatheter arterial embolization (TAE). The PV branch was punctured percutaneously and a guidwire was inserted into the PV,then an indwelling catheter was introduced to the superior mesentric vein or splenic vein. The port was implanted subcutaneously in the right upper abdomen and connected with the catheter.Results:The technical success rate was 100% without procedure related complications. The indwelling catheter migrated into abdominal cavity after the procedure in two cases. Conclusion: it was suggested that the technique is safe and reliable, and can provide access for intraportal chemotherapy to treat liver malignancies.