Experience with the use of intraperitoneal aerosol chemotherapy under pressure for the treatment of peritoneal carcinomatosis of the hepatopancreatoduodenal zone

Objective: To study the efficacy and safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with malignant tumors of the hepatopancreatoduodenal zone and associated peritoneal carcinomatosis. Materials and Methods: The study included 17 patients with malignant neoplasms of the hepatopancreatoduodenal zone and peritoneal carcinomatosis. From 2021 to 2025, they underwent laparoscopic PIPAC using standard chemotherapy regimens alongside systemic therapy. Results: All patients underwent 51 PIPAC procedures, an average of three sessions per patient. The majority of participants were men (82.3%), with a mean age of 59 years. ECOG performance status of 0-1 was 94.1%. The primary diagnosis was pancreatic cancer in 88.2% of cases. All patients had previously undergone complete cytoreduction. Peritoneal lesions primarily manifested as low to moderate PCI levels, with no lesions larger than 5 cm. The average session duration was 98.6 minutes, blood loss was 110 ml, and hospital stay was 1.85 days; no complications or fatalities were recorded. According to the PRGS scale, after three procedures, a complete pathological response was observed in 29.4% of patients, regression in 35.3%, stabilization in 29.4%, and progression in 5.9%. With >=2 PIPAC sessions, the pathological response rate reached 90%. Conclusion: Pressurized intraperitoneal aerosol chemotherapy for patients with peritoneal hepatopancreaticoduodenal carcinomatosis has demonstrated good tolerability, a high pathological response rate, and significant tumor regression. This method is effective as an adjunct to systemic chemotherapy, improving local disease control and increasing patient survival.