Portal embolization for hepatic cancer treatment

(A)为了选择安全、完全的选择性门静脉分支阻断(SPBO)材料，我们用兔进行了实验。结果表明，水化明胶粉最适合作为临时门静脉阻断材料，因为在2周内肝组织结构无组织学异常。对于永久性闭塞，明胶包埋后加用少量油酸乙醇胺是安全有效的。在肝癌患者中，我们成功地完成了术中带瘤肝段的sPBO手术，通过我们设计的四腔双气囊导管，术中出血量明显减少，而术后肝功能不增加。(2)对于肝癌患者，我们尝试在肝动脉栓塞术(TAE)后行带癌肝段sPBO，治疗后约1个月行肝切除术。所有病例均痊愈出院，无严重并发症。TAE后1周内接受sPBO治疗的肿瘤细胞几乎全部坏死。(3)TAE联合sPBO短期内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.