An experimental minimally invasive perfusion technique for the treatment of liver metastases.
OBJECTIVE
Isolated hepatic perfusion (IHP) is an invasive, technically difficult, non-repeatable and demanding operation. In this study we report the development of a less invasive alternative for the surgical IHP in a pig model.


METHODS
Our technique was tested in 8 Yorkshire pigs (60 kg). The liver was isolated from the systemic circuit using minimally invasive techniques: an occlusion stent-graft and balloon catheters, with reversal of the blood flow through the liver during IHP.


RESULTS
Tests with varying pressures applied at the PV revealed a clear relation between the suction pressure at the outflow site (PV), intrahepatic pressure and systemic leakage of 99mTc. A leakage-free IHP could be obtained in seven separate experiments.


CONCLUSIONS
Isolated hepatic perfusion using minimally invasive techniques is feasible in pigs when the intrahepatic pressure is controlled. This technique has yet to be tested in patients.
Rothbarth
J
J
Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Pijl
M E J
ME
Tollenaar
R A E M
RA
Tijl
F
F
Ivancev
G
G
Mulder
G J
GJ
Kuppen
P J K
PJ
van de Velde
C J H
CJ
Schultze Kool
L J
LJ
D000818:Animals; D010478:Chemotherapy, Cancer, Regional Perfusion; D004195:Disease Models, Animal; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D019060:Minimally Invasive Surgical Procedures; D009362:Neoplasm Metastasis; D013552:Swine; D016896:Treatment Outcome