Eid A, Reissman P, Zamir G, Pikarsky A J
Department of General Surgery and Transplantation, Hadassah University Hospital, Kiryat Hadassah, Jerusalem, Israel.
Am Surg. 1998 Mar;64(3):261-2.
Intra-arterial hepatic chemotherapy using an implantable subcutaneous port with a catheter inserted into the gastroduodenal artery is an acceptable treatment for patients with isolated, nonresectable liver metastases from colorectal cancer. Because of the common variations of hepatic arterial anatomy occurring in about one-half of the patients, this technique will result in complete perfusion of both hepatic lobes only in those with "classical" arterial anatomy (Michels type I). Many techniques have been described in these situations, usually using a dual-catheter port with the attendant risk of hepatic misperfusion and arterial thrombosis. We herein describe an alternative technique applicable to patients with a right hepatic artery arising from the superior mesenteric artery. In this technique the right hepatic artery is anastomosed end-to-end with the gastroduodenal artery, followed by implantation of a single-catheter port that is inserted into the splenic artery.
使用可植入皮下端口并将导管插入胃十二指肠动脉进行肝动脉内化疗，对于患有孤立性、不可切除的结直肠癌肝转移患者是一种可接受的治疗方法。由于约一半患者存在肝动脉解剖结构的常见变异，这种技术仅在具有“经典”动脉解剖结构（Michels I型）的患者中才能实现肝两叶的完全灌注。在这些情况下已经描述了许多技术，通常使用双导管端口，但存在肝灌注不良和动脉血栓形成的风险。我们在此描述一种适用于肠系膜上动脉发出右肝动脉的患者的替代技术。在该技术中，将右肝动脉与胃十二指肠动脉进行端端吻合，然后植入一个插入脾动脉的单导管端口。
