Cryodestruction in locally spreaded pancreatic cancer

Abstract

Background: Сombined treatment for patients with metastatic liver damage offers better long-term outcome, and laser ablation can increase the indications for liver resection for somatically burdened patients. Methods: The Results of treatment of 28 patients with metastatic liver damage and using laser ablation technique for the period from March 2017 to 2018, women 17, men 11, average age was 61 AE 2.7 years. All patients in the preoperative stage performed removal of the primary focus in the volume of R0 and lymphadenectomy D1, D2 and are at different stages of chemotherapy. Laser ablation of liver formations was performed percutaneously transhepatic, under the control of ultrasonic scanning in real time. For laser ablation, ECHO LASER, manufactured in Italy, was used, a 4-channel multiple source with a complex ultrasound system, using laser radiation with a wavelength of 1064 nm. Control of the effectiveness of the effect was carried out by ultrasound, MRI and CT with intravenous bolus enhancement in dynamics. Result: In the early postoperative period pain syndrome was noted, within 3 days, stopped with the use of analgesics, biochemical analyzes (ALT, AST, AP) were observed for 10 days. In the early postoperative period, formation under the capsular hematoma, in the area of "h"hthe light guide, was not required, which did not require surgical intervention. In 4 patients, at 6 months, progression of the disease was noted, followed by liver resection. Morphological examination of the ablation zone shows pathomorphosis of the fourth degree (according to Lushnikov). The average bed-day was 4 days. Conclusion:The use of laser ablation allows several nodes to act simultaneously. Due to low traumatism and