Portal embolization for hepatic cancer treatment

(a)为了选择合适的材料进行安全、完全的选择性门静脉支闭塞（sPBO），我们采用家兔进行了实验。因此，水合明胶粉被证明是最适合的临时门静脉闭塞材料，因为在2周内，肝组织结构没有组织学异常。对于永久性闭塞，明胶栓塞后加入少量油酸乙醇胺是安全有效的。在肝癌患者中，我们通过自行设计的4管腔双球囊导管给药，成功完成了术中肝癌肝段sPBO，术中出血量明显减少，术后肝功能未加重。(b)术前肝癌患者，我们尝试经动脉栓塞（TAE）后对荷瘤肝段行sPBO，治疗约1个月后行肝切除术。所有病例均痊愈，无严重并发症。经组织学检查发现，在TAE术后1周内行sPBO的患者肿瘤细胞几乎已坏死。(c)综上所述，短期内联合TAE和sPBO治疗肝癌可能是一种有效的治疗方法。

(a) To chose the suitable materials for safe and complete selective protal branch occlusion (sPBO), we made the experiments using rabbits. As a result, hydrated gelatin powder was proved to be the most suitable for the temporary portal occlusion material, because within 2 weeks no histological abnormality was remained in the hepatic tissue architecture. For the permanent occlusion, it is effective and safe to add a small amount of ethanolamin oleate after gelatin emboilization. In the liver cancer patients, we successfully accomplished intraoperative sPBO of the liver segment with cancer by administration of these materials via double balloon catheter with 4 lumens, which we had deviced, and resulted in marked decrease of intraoperative blood loss with no increase of the postoperative liver dysfunction.(b) In preoperative liver cancer patients, we tried to perform the sPBO of the cancer bearing hepatic segment after transarterioal embolization (TAE) and about 1 month after these treatments, we performed hepatectomy. All cases recovered with no serious complication. By the histological examination of the resected material, it was also demonstrated that the tumor cells were almost fallen in necrosis in cases received sPBO within 1 week after TAE.(c) In conclusion, combination treatment with TAE and sPBO within a short period should be a possible effective therapy for liver cancer.