Document Detail

Hepatic artery infusion pumps: cannulation techniques and other surgical considerations.
MedLine Citation:
PMID:  2139485     Owner:  NLM     Status:  MEDLINE    
Long term hepatic artery chemotherapy for metastatic disease to the liver has been made practical by technologic advances in pumps and catheters. The surgical placement of these pumps and catheters can be associated with a significant morbidity unless careful attention is given to variations in hepatic arterial anatomy and to eliminating collateral arterial supply to the distal stomach and duodenum. Gastroduodenal devascularization should be performed in all patients and should be confirmed both with intra-operative fluorescein injection and postoperative scintigraphy scanning. Routine cholecystectomy avoids the complication of chemical cholecystitis. Exact placement of the catheter tip at the junction of the gastroduodenal artery and the hepatic artery with fixation of the catheter in this position by placement of bidirectional ligatures around the catheter bead will reduce the incidence of hepatic artery thrombosis and catheter migration. Intrahepatic arterial collateralization in most patients allows for ligation of variant lobar vessels with total liver perfusion through the remaining lobar arterial supply. This again can be confirmed intra-operatively with fluorescein injection and postoperatively with scintigraphy scanning. Strict attention to these technical details will allow continued use of this important therapeutic modality in the treatment of hepatic metastases and by minimizing surgical complications will encourage continued trials to improve the efficacy of long term hepatic arterial chemotherapy.
S A Curley; D C Hohn; M S Roh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Langenbecks Archiv für Chirurgie     Volume:  375     ISSN:  0023-8236     ISO Abbreviation:  Langenbecks Arch Chir     Publication Date:  1990  
Date Detail:
Created Date:  1990-05-31     Completed Date:  1990-05-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0204167     Medline TA:  Langenbecks Arch Chir     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  119-24     Citation Subset:  IM    
University of Texas M.D. Anderson Cancer Center, Houston.
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MeSH Terms
Floxuridine / administration & dosage*
Fluorouracil / administration & dosage*
Hepatic Artery / surgery*
Infusion Pumps, Implantable*
Infusions, Intra-Arterial / instrumentation*
Liver Neoplasms / drug therapy,  secondary*
Postoperative Complications / prevention & control
Reg. No./Substance:
50-91-9/Floxuridine; 51-21-8/Fluorouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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