Objective To investigate the safety and feasibility of transcatheter arterial chemoembolization (TACE) assisted by transradial approach and cone beam computed tomography (CBCT) three-dimensional vascular reconstruction in the treatment of primary liver cancer. Methods The clinical data of 124 patients with primary liver cancer who underwent precision TACE via radial artery in our hospital from May 2018 to December 2019 were retrospectively collected. Results Among the 124 patients, 118 patients were successfully punctured through the left radial artery and completed the TACE operation. The operation time was (109.57±31.32) min, and the median of postoperative hospitalization was 3 d. One patient changed to the right radial artery to complete TACE due to chronic renal failure and left brachial artery and vein puncture and catheterization before operation. The operation time was 119 minutes, and the patient was discharged after 5 days of hospitalization. After successful puncture of the left radial artery in one patient, the forearm artery was twisted into a loop and the guide wire catheter failed to pass, and the right femoral artery was used to complete TACE. The operation time was 123 minutes, and the patient was discharged after 4 days of improvement. The radial artery puncture was unsuccessful in four patients, and the right femoral artery approach was used to complete the operation; the operation time was (111.66±32.77) min, and the median of postoperative hospitalization was 3 d. One of the patients successfully completed up to 5 consecutive TACE via the radial artery. All patients underwent precision TACE with superselective cannulation assisted by CBCT three-dimensional vascular reconstruction. No vascular injury andocclusion, urinary retention, subcutaneous hemorrhage, and other complications occurred in all patients. Conclusions Trans-radial arterial precision TACE is safe and effective, which can be repeated many times and has few complications and high patient comfort. It can be used as one of the routine approaches of TACE.
ObjectiveTo explore the safety and feasibility of retrolaparoscopy in treatment of severe acute pancreatitis complicated with infected pancreatic necrosis. MethodsClinical data of 20 patients with severe acute pancreatitis complicated with infectious pancreatic necrosis who received retrolaparoscopy treatment in our hospital from May 2017 to May 2022 were retrospectively collected. ResultsAmong the 20 patients, 18 patients underwent percutaneous catheter drainage, 1 pregnant patient with severe acute pancreatitis underwent laparotomy drainage in the first phase, and 1 patient underwent laparotomy drainage in the first phase from another hospital. All patients underwent successful retroperitoneal drainage, microscopic debridement and drainage were performed. The operation time was 68–106 minutes, (89.8±11.7) minutes; intraoperative bleeding was 100–300 mL, (171.3±61.0) mL; hospitalization was 28–62 d, with median time of 48 d. After the operation, the systemic poisoning symptoms of the patients were quickly relieved. One patient underwent twice retroperitoneoscopic debridement surgeries, and the remaining patients underwent only once retroperitoneoscopic debridement drainage surgery. There were no complications in 17 patients, but 1 patient was complicated by colonic fistula after surgery, 2 patients suffered from abdominal bleeding. After the operation, 20 patients were interviewed, and the follow-up time was 6–62 months, with the median of 31 months. During postoperative follow-up period, the patients’ symptoms completely disappeared and there was no recurrence. ConclusionThe retrolaparoscopic approach in treatment of severe acute pancreatitis complicated with infected pancreatic necrosis is safe and effective, and has few complications.