Hepatic artery cannulation

1. Larger liver tumors cannot be removed in one stage. Tumors occupy less than 50% of the total liver area, such as those with cirrhosis, and less than 75% of those without cirrhosis. They can be used for arterial infusion chemotherapy to reduce the tumor, so as to reduce the possibility of second-stage resection. 2. No jaundice or ascites. Treatment of diseases: cirrhosis, ascites, liver tumor, liver cirrhosis Indication 1. Larger liver tumors cannot be removed in one stage. Tumors occupy less than 50% of the total liver area, such as those with cirrhosis, and less than 75% of those without cirrhosis. They can be used for arterial infusion chemotherapy to reduce the tumor, so as to reduce the possibility of second-stage resection. 2. No jaundice or ascites. Preoperative preparation Liver and procoagulant therapy. Surgical procedure In the right upper abdomen or through the right rectus abdominis incision, the antrum is opened after laparotomy, the right gastric artery is found on the curved side of the antrum, and an artery of about 1 cm is separated, and two No. 4 silk wires are inserted. Ligation, the end of the line is not cut, the assistant tightens the proximal end of the artery without ligature, the surgeon cuts the anterior wall of the artery with small scissors between the two lines, and the left hand holds the anterior wall of the artery with the pointed tweezer, right hand The tweezers clamped the plastic tube with the outer diameter of 3~4mm into the artery incision, and sent the plastic tube inward while relaxing the proximal thread. After inserting 5~6cm, the left thumb and the middle finger were inserted into the hepatoduodenal ligament from the small omentum hole. At the rear, the thumb is placed in front of the hepatoduodenal ligament, touching the plastic tube and assisting the guiding, so that the plastic tube is inserted into the hepatic artery. The proximal line of the right aortic artery of the gastric retina was ligated. The catheter is inserted into the proper hepatic artery, the right hepatic artery, or the left hepatic artery according to the location of the tumor. To confirm the position of the catheter, 2 ml of methylene blue can be injected. If the right half of the liver is immediately stained with blue, it is confirmed that the catheter is already in the right hepatic artery, and vice versa. The catheter is repeatedly fixed on the omentum and the peritoneum several times, and the abdominal wall is taken out and fixed on the skin of the abdominal wall with a silk thread. Can also be intubated from the right gastric artery, gastroduodenal artery to the hepatic artery.

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