METHOD FOR COMBINED TREATMENT OF PATIENTS AFFECTED WITH INOPERABLE TUMORS IN HEPATO-PANCREATO-DUODENAL ZONE

摘要

FIELD: medicine. SUBSTANCE: patients affected with proximal tumors complicated with mechanical icteric disease in hepato-pancreato-duodenal area are subjected to treatment by transcutaneous transhepatic cholangiostomy by pacing catheter No. 12 in right hepatic lobe duct, upstream of point of its obturation with tumor. System of biliary ducts is subjected to external and internal drainage using catheter thus-placed, while, simultaneously, effecting intensive desintoxicating and antiinflammatory therapy for 2 weeks, during which period patients take in their own before each meal one week after cholangiostomy. Next catheter is removed, and duct portion obturated by tumor is subjected to bouginage. Thereafter, under X-raying control, catheter No. 12 is passed through this duct portion all the way up to distal boundary of tumor. Next intrastate of apparatus for intracavitary radiative therapy is introduced into aperture of catheter No. 12 up to same boundary. Onto free end of intrastat mark is traced relative to catheter fixed on skin. Next gamma-radiation source ¹⁹²Ir is inserted into aperture of intrastat to effect intraduct irradiation according to dosimetric scheme. During subsequent irradiation procedures intrastat is inserted into catheter down to depth corresponding to mark thus-traced. Intraduct irradiation treatment is simultaneously accompanied with remotely effected radiation therapy. Finally, upon completion of treatment course, endoprosthesis (made on Nitinol) with self-straightening carcass is introduced through catheter. EFFECT: higher efficiency of treatment.