Temporary liver dearterialization in patients with metastatic carcinoid disease

Abstract

AbstractThe surgical treatment of liver metastases from carcinoid tumors is burdened by a relatively poor symptomatic relief and a high mortality rate. Temporary liver dearterialization, separating the operative trauma from the temporary hepatic occlusion, may have advantages. We have utilized this treatment in 16 patients. The effect of treatment was registered in symptomatic relief, changes in urinary 5‐HIAA, serotonin in platelet‐poor plasma, and morphologic changes shown by angiography.Fourteen patients, who underwent only the dearterialization procedure, survived the immediate postoperative period, while 2 patients who had concomitant small bowel resection both died of complications, 1 and 3 months postoperatively, respectively. One patient died, 14 months postoperatively, of the carcinoid disease. All but 1 patient were free from symptoms for at least 6 months. Two patients have had no recurrence of the carcinoid syndrome for 34 and 42 months, respectively. A decrease in urinary 5‐HIAA was seen after 6 months in 10 patients, serotonin declined in 7 patients, and angiography showed regression in 7 patients. The results of this study indicate that temporary liver dearterialization is a safe procedure with low mortality and good symptomatic relief from the carcinoid syndrome.