Reflux of ethanol during experimental liver ethanol injections.

Abstract

The reflux of ethanol into the peritoneal cavity during percutaneous ethanol injection therapy (PEIT) of liver neoplasms may cause pain and other side effects. This article studies the optimal injection technique to minimize the reflux of ethanol. A technique using normal postmortem pig livers was developed to measure the amount of reflux in different experimental injection situations. The proportional reflux increased significantly when the needle diameter (0.55-1.1 mm) was larger (P < .01) and when the injection was more superficial (P < .0005) (ie, the needle traversed a shorter distance [1-5 cm] inside the liver tissue). Speeding up the injection (0.13-1.5 g/second) produced suggestive (P < .10) increase of the proportional reflux. The proportional reflux was not affected by either the ethanol dose (0.40-2.06 g) or by the time lapse (0-30 seconds) after the injection when the needle was left in situ before its withdrawal. The reflux of ethanol during PEIT is influenced by the diameter of the needle and by the technique used. Further studies are needed to fully clarify the clinical validity of these results.