Gallbladder cancer chemotherapy, advanced gallbladder carcinoma development in addition to a direct violation of the liver capsule outside, and through the lymphatic vessels to lymph nodes and hilar lymph node within the hepatoduodenal ligament, leading to the pancreatic head area hilar mass and obstructive jaundice; also to the blood channel and distant organ metastasis liver. The development of the capsule gallbladder, surgical removal of a large lower rate, so the survival rate is extremely low. Comprehensive measures to kill or restrict foreign invasion or metastasis capsule, creating opportunities for stage surgical resection; or combined with surgery, supplementary measures for residual tumor after surgery to kill tumor or cancer group, the focus of research in recent years, which play an important role in the strong measures are (super) selective cystic artery or hepatic artery infusion technology.
1. Selective arterial embolization
Indications and contraindications: gallbladder infiltrating the liver, gall bladder can be seen moving pulse of the right hepatic artery and anastomosis between the formation, super choice if anastomosis to these abnormal blood supply of dry and viable anti-cancer drugs lipiodol emulsion embolization. Early gallbladder cancer, gall bladder necrosis caused by cystic artery embolization; recent lymph node metastasis of gallbladder carcinoma, gastric and pancreatic embolism caused severe reactions, these two cases can not be embolization.
2. Selective arterial infusion chemotherapy
Indications: relative limitations, only direct invasion of neighboring advanced liver cancer, surgical resection and to ensure removal of residual tumor cells after the killing, should be carried out in the preoperative and postoperative arterial chemotherapy, respectively. Liver infiltration and hilar lymph nodes, etc. arterial chemotherapy of advanced cancer is the development of effective cancer control measures with other measures to support a regular basis.
Contraindications: serious physical weakness, liver, kidney, heart and bone marrow function was incomplete, not suitable for chemotherapy.
Method:
(1) the patient to prepare: Check the specific operation or puncture live pathologic types of chemotherapy drugs to specific gallbladder. Tumor imaging data clearly scope to guide the choice of arterial cannulation and subsequent clinical efficacy were measured, it is best for the CT or MRI, and detailed ultrasound examination can also meet the requirements. Other conventional angiography preparation.
(2) equipment ready: with liver cancer.
(3) perfusion method: similar to liver cancer. Cystic artery originated from right hepatic artery, early gallbladder to superselective right hepatic artery to the gallbladder to the artery infusion chemotherapy, ultra-thin dielectric cystic artery into the difficult choice that can be used than the sponge next to the remote branch of right hepatic artery embolization, and later by right hepatic artery perfusion, most drugs can enter the cystic artery.
Advanced gallbladder cancer more violations when violations of the right lobe of the liver front, this time to the right hepatic artery intubation chemotherapy, which can take into account the primary carcinoma of gallbladder and liver carcinoma.
Gallbladder cancer chemotherapy in advanced gallbladder violations such as the liver and a hilar lymph node metastasis, simply insert the catheter to the artery, gallbladder cancer chemotherapy drug infusion into the hepatic artery can be, cystic artery and the gastroduodenal artery , taking into account the primary gallbladder cancer, liver carcinoma and liver metastasis of lymph nodes ligament. Compression caused by metastatic lymph node of biliary obstructive jaundice but also percutaneous biliary drainage, bile duct dilatation or biliary stent implantation.