tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2025-056tumors-1493Research ArticleСОБСТВЕННЫЕ ИССЛЕДОВАНИЯ. ВОПРОСЫ ОНКОХИРУРГИИOWN RESEARCH. ONCOSURGERY ISSUESРоль предоперационной эмболизации общей печеночной артерии у больных с опухолями тела и хвоста поджелудочной железы с инвазией чревного стволаThe role of preoperative embolization of the common hepatic artery in patients with tumors of the body and tail of the pancreas with invasion of the celiac trunkhttps://orcid.org/0000-0001-8893-1894АбгарянМ. Г.AbgaryanM. G.

Абгарян Микаэл Грантович 

115478 Москва, Каширское шоссе, 23

Abgaryan Mikael Grantovich 

23 Kashirskoe Shosse, Moscow 115478

abgaryan.mikael@gmail.comhttps://orcid.org/0000-0002-4006-3642ВиршкеЭ. Р.VirshkeE. R.

Виршке Эдуард Рейнгольдович 

115478 Москва, Каширское шоссе, 23

Virshke Eduard Reingoldovich

23 Kashirskoe Shosse, Moscow 115478

https://orcid.org/0000-0002-2811-0549КотельниковА. Г.KotelnikovA. G.

Котельников Алексей Геннадьевич 

115478 Москва, Каширское шоссе, 23

Kotelnikov Alexey Gennadievich

23 Kashirskoe Shosse, Moscow 115478

https://orcid.org/0000-0003-2586-8562БердниковС. Н.BerdnikovS. N.

Бердников Сергей Николаевич 

115478 Москва, Каширское шоссе, 23

Berdnikov Sergey Nikolaevich

23 Kashirskoe Shosse, Moscow 115478

https://orcid.org/0000-0001-7375-3378ПодлужныйД. В.PodluzhnyD. V.

Подлужный Данил Викторович 

115478 Москва, Каширское шоссе, 23

Podluzhny Danil Viktorovich

23 Kashirskoe Shosse, Moscow 115478

https://orcid.org/0000-0002-8681-7905ЕгеновО. А.EgenovO. A.

Егенов Омар Алиевич 

115478 Москва, Каширское шоссе, 23

Egenov Omar Alievich

23 Kashirskoe Shosse, Moscow 115478

https://orcid.org/0000-0002-3524-1037АвдюхинИ. Г.AvdyukhinI. G.

Авдюхин Иван Геннадьевич 

115478 Москва, Каширское шоссе, 23

Avdyukhin Ivan Gennadievich

23 Kashirskoe Shosse, Moscow 115478

ФГБУ «Научный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaRussian Federation2025301020251534652Copyright © Абгарян М.Г., Виршке Э.Р., Котельников А.Г., Бердников С.Н., Подлужный Д.В., Егенов О.А., Авдюхин И.Г., 20252025Абгарян М.Г., Виршке Э.Р., Котельников А.Г., Бердников С.Н., Подлужный Д.В., Егенов О.А., Авдюхин И.Г.Abgaryan M.G., Virshke E.R., Kotelnikov A.G., Berdnikov S.N., Podluzhny D.V., Egenov O.A., Avdyukhin I.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/1493

Цель исследования: Определить показания и оценить безопасность и эффективность предоперационной эмболизации общей печеночной артерии у больных с инвазией чревного ствола при раке тела и хвоста поджелудочной железы.Материал и методы: Дистальная субтотальная резекция поджелудочной железы с резекцией чревного ствола и общей печеночной артерии произведена 32 больным. Из них у 8 была выполнена предоперационная эмболизация общей печеночной артерии. Показанием служило отсутствие адекватного коллатерального кровотока по панкреатодуоденальным аркадам.Результаты: У 8 больных, которым была выполнена предоперационная эмболизация общей печеночной артерии, во всех случаях удалось полностью перекрыть кровоток по общей печеночной артерии, несмотря на наличие инвазии чревного ствола. Осложнений при выполнении рентгеноэндоваскулярного вмешательства не было. При контрольной верхней мезентерикографии у всех больных отмечалось адекватное кровоснабжение печени за счет развития коллатерального кровотока из бассейна верхней брыжеечной артерии. В послеоперационном периоде ишемических осложнений со стороны печени не отмечено, однако у одного больного развилась клиника острого холецистита, который купирован на фоне консервативной терапии.Выводы: Предоперационная эмболизация общей печеночной артерии является технически выполнимой и безопасной процедурой, позволяющей снизить риск ишемических осложнений у больных, перенесших дистальную субтотальную резекцию поджелудочной железы с резекцией чревного ствола и общей печёночной артерии без ангиопластики.

The aim of the study was to determine the indications and evaluate the safety and effectiveness of preoperative embolization of the common hepatic artery in patients with the tumors of the pancreatic body and tail with celiac trunk invasion.

Materials and methods

Materials and methods: Distal subtotal resection of the pancreas with resection of the celiac trunk and the common hepatic artery was performed in 32 patients. Of these, 8 had preoperative embolization of the common hepatic artery. The indication was the lack of adequate collateral blood flow through the pancreaticoduodenal arcades.

Results

Results: Complete block of the common hepatic artery blood flow was achieved in all 8 patients who underwent preoperative embolization of the common hepatic artery, despite invasion of the celiac trunk. There were no com­plications during X-ray-guided endovascular intervention. A follow-up upper mesenteric angiography demonstrated adequate blood supply to the liver in all patients due to the development of collateral blood flow from the superior mesenteric artery territory. No ischemic complications in the liver were observed in the postoperative period, however, one patient had clinical manifestations of acute cholecystitis, which was relieved by conservative therapy.

Conclusions

Conclusions: Preoperative embolization of the common hepatic artery is a technically feasible and safe procedure that reduces the risk of ischemic complications in patients who have undergone distal subtotal resection of the pancreas with resection of the celiac trunk and common hepatic artery without angioplasty.

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The authors declare that there are no conflicts of interest present.