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Treatment of Patients With Hepatic Tumors and Jaundice by Ligation of the Hepatic Artery

Treatment of Patients With Hepatic Tumors and Jaundice by Ligation of the Hepatic Artery Abstract Ligation of the hepatic artery without complete dissection of the liver was performed on eight patients with nonresectable hepatic tumors. Three patients had a marked preoperative clinical and chemical obstructive, intrahepatic jaundice, which disappeared postoperatively. Relief of pain and decrease of enlarged liver were initially noticed in seven patients. Hepatic sepsis was a serious complication with fatal outcome in one nonjaundiced man. The hypoxic necrosis of tumors resulting in a remission of symptoms in the survivors and the disappearance of cholestasis in three jaundiced patients was, however, temporary. After two to six months, the jaundice and other symptoms recurred. The conclusion is drawn that a prolonged life expectancy is perhaps not obtained, but a worthwhile, symptomatic improvement and palliative effect can be achieved by hepatic artery ligation. References 1. Wright RD: The blood supply of newly developed epithelial tissue in the liver . J Pathol 45:405-414, 1937.Crossref 2. Breedis C, Young G: The blood supply of neoplasma in the liver . Am J Pathol 30:969-985, 1954. 3. Markowitz J: The hepatic artery . Surg Gynecol Obstet 95:644-646, 1952. 4. Reinhoff HF, Woods AC: Ligation of hepatic and splenic arteries in treatment of cirrhosis with ascites . JAMA 152:687-690, 1953.Crossref 5. Nilsson LAV: Therapeutic hepatic artery ligation in patients with secondary liver tumors . Rev Surg 23:374-376, 1966. 6. Nilsson LAV, Rudenstam CM, Zettergren L: Vascularisation of liver tumours and the effect of hepatic artery ligature . Bibl Anat 9:425-431, 1967. 7. Nilsson LAV, Zettergren L: Effect of hepatic artery ligation of induced primary liver carcinoma in rats . Acta Pathol Microbiol Scand 71:187-193, 1967.Crossref 8. Almersjö O, et al: Hepatic artery ligation as pretreatment for liver resection of metastatic cancer . Rev Surg 23:377-380, 1966. 9. Almersjö O, et al: Serum lipids after hepatic artery ligation in man . Scand J Gastroenterol 1:207-213, 1966. 10. Almersjö O, et al: Serum enzyme changes after hepatic dearterialization in man . Ann Surg 167:9-17, 1968.Crossref 11. Almersjö O, et al: Changes in coagulation factors after hepatic dearterialization in man . Am J Surg 116:414-418, 1968.Crossref 12. Bengmark S, et al: Die chirurgische Behandlung von Lebertumoren . Chirurg 39:320-325, 1968. 13. Bengmark S, Hofström LO: The natural history of primary and secondary malignant tumors of the liver: I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy . Cancer 23:198-202, 1969.Crossref 14. Gelin LE, Lewis DH, Nilsson L: Liver blood flow in man during abdominal surgery: II. The effect of hepatic artery occlusion on the blood flow through metastatic tumor nodules . Acta Hepatosplenol (Stuttg) 15:21-24, 1968. 15. Balasegaram M: Complete hepatic dearterialization for primary carcinoma of the liver: Report of 24 patients . Am J Surg 124:340-345, 1972.Crossref 16. Plengvanitis U, et al: Treatment of primary carcinoma of the liver by hepatic artery ligation: Preliminary report of 10 cases . Tijdschr Gastroenterol p 490, 1967. 17. Almersjö O, et al: Evaluation of hepatic dearterialization in primary and secondary cancer of the liver . Am J Surg 124:5-9, 1972.Crossref 18. Counaud C: Ligature de l'artère hépatique et désartérialisation hépatique . J Chir (Paris) 104:7-22, 1972. 19. Koudahl G, Andreassen M: Ligation of the hepatic artery in treatment of diseases of the liver and the biliary tract . Chir Gastroenterol 5:207-208, 1971. 20. Aune S, Schistad G: Carcinoid liver metastases treated with hepatic dearterialization . Am J Surg 123:715-717, 1972.Crossref 21. Madding GF, Kennedy PA, Sogemeier E: Hepatic artery ligation for metastatic tumor in the liver . Am J Surg 120:95-96, 1970.Crossref 22. Bengmark S, Rosengren K: Angiographic study of the collateral circulation to the liver after ligation of the hepatic artery in man . Am J Surg 119:620-624, 1970.Crossref 23. Hutchinson JH, Lobby DH: New method for microdetermination of blood ammonia by use of cation exchange resin . J Lab Clin Med 60:170-178, 1962. 24. Ervasti J: Primary carcinoma of the liver . Acta Chir Scand [Suppl] 334, 1964. 25. Murray-Lyon IM, et al: Treatment of secondary hepatic tumours by ligation of hepatic artery and infusion of cytotoxic drugs . Lancet 2:172-175, 1970.Crossref 26. Lin TY: Primary cancer of the liver . Scand J Gastroenterol 5:223-241, 1970. 27. Longmire WP Jr, Sandford MC: Intrahepatic cholangiojejunostomy with partial hepatectomy for biliary obstruction . Surgery 24:264-276, 1948. 28. Zieve L: Pathogenesis of hepatic coma . Arch Intern Med 118:211-223, 1966.Crossref 29. Bengmark S, et al: A twostage liver resection combined with long-term intraportal 5-Fu infusion. Rev Surg, to be published. 30. Hafström LO, Zettergren L, Åkesson L-Ä: The natural history of primary and secondary malignant tumours of the liver: IV. The prognosis for patients with carcinoma of the gallbladder, with special reference to the amount of tumour growth within the liver at time of diagnosis . Acta Chir Scand 139:264-269, 1973. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Treatment of Patients With Hepatic Tumors and Jaundice by Ligation of the Hepatic Artery

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Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1974.01350260034007
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Abstract

Abstract Ligation of the hepatic artery without complete dissection of the liver was performed on eight patients with nonresectable hepatic tumors. Three patients had a marked preoperative clinical and chemical obstructive, intrahepatic jaundice, which disappeared postoperatively. Relief of pain and decrease of enlarged liver were initially noticed in seven patients. Hepatic sepsis was a serious complication with fatal outcome in one nonjaundiced man. The hypoxic necrosis of tumors resulting in a remission of symptoms in the survivors and the disappearance of cholestasis in three jaundiced patients was, however, temporary. After two to six months, the jaundice and other symptoms recurred. The conclusion is drawn that a prolonged life expectancy is perhaps not obtained, but a worthwhile, symptomatic improvement and palliative effect can be achieved by hepatic artery ligation. References 1. Wright RD: The blood supply of newly developed epithelial tissue in the liver . J Pathol 45:405-414, 1937.Crossref 2. Breedis C, Young G: The blood supply of neoplasma in the liver . Am J Pathol 30:969-985, 1954. 3. Markowitz J: The hepatic artery . Surg Gynecol Obstet 95:644-646, 1952. 4. Reinhoff HF, Woods AC: Ligation of hepatic and splenic arteries in treatment of cirrhosis with ascites . JAMA 152:687-690, 1953.Crossref 5. Nilsson LAV: Therapeutic hepatic artery ligation in patients with secondary liver tumors . Rev Surg 23:374-376, 1966. 6. Nilsson LAV, Rudenstam CM, Zettergren L: Vascularisation of liver tumours and the effect of hepatic artery ligature . Bibl Anat 9:425-431, 1967. 7. Nilsson LAV, Zettergren L: Effect of hepatic artery ligation of induced primary liver carcinoma in rats . Acta Pathol Microbiol Scand 71:187-193, 1967.Crossref 8. Almersjö O, et al: Hepatic artery ligation as pretreatment for liver resection of metastatic cancer . Rev Surg 23:377-380, 1966. 9. Almersjö O, et al: Serum lipids after hepatic artery ligation in man . Scand J Gastroenterol 1:207-213, 1966. 10. Almersjö O, et al: Serum enzyme changes after hepatic dearterialization in man . Ann Surg 167:9-17, 1968.Crossref 11. Almersjö O, et al: Changes in coagulation factors after hepatic dearterialization in man . Am J Surg 116:414-418, 1968.Crossref 12. Bengmark S, et al: Die chirurgische Behandlung von Lebertumoren . Chirurg 39:320-325, 1968. 13. Bengmark S, Hofström LO: The natural history of primary and secondary malignant tumors of the liver: I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy . Cancer 23:198-202, 1969.Crossref 14. Gelin LE, Lewis DH, Nilsson L: Liver blood flow in man during abdominal surgery: II. The effect of hepatic artery occlusion on the blood flow through metastatic tumor nodules . Acta Hepatosplenol (Stuttg) 15:21-24, 1968. 15. Balasegaram M: Complete hepatic dearterialization for primary carcinoma of the liver: Report of 24 patients . Am J Surg 124:340-345, 1972.Crossref 16. Plengvanitis U, et al: Treatment of primary carcinoma of the liver by hepatic artery ligation: Preliminary report of 10 cases . Tijdschr Gastroenterol p 490, 1967. 17. Almersjö O, et al: Evaluation of hepatic dearterialization in primary and secondary cancer of the liver . Am J Surg 124:5-9, 1972.Crossref 18. Counaud C: Ligature de l'artère hépatique et désartérialisation hépatique . J Chir (Paris) 104:7-22, 1972. 19. Koudahl G, Andreassen M: Ligation of the hepatic artery in treatment of diseases of the liver and the biliary tract . Chir Gastroenterol 5:207-208, 1971. 20. Aune S, Schistad G: Carcinoid liver metastases treated with hepatic dearterialization . Am J Surg 123:715-717, 1972.Crossref 21. Madding GF, Kennedy PA, Sogemeier E: Hepatic artery ligation for metastatic tumor in the liver . Am J Surg 120:95-96, 1970.Crossref 22. Bengmark S, Rosengren K: Angiographic study of the collateral circulation to the liver after ligation of the hepatic artery in man . Am J Surg 119:620-624, 1970.Crossref 23. Hutchinson JH, Lobby DH: New method for microdetermination of blood ammonia by use of cation exchange resin . J Lab Clin Med 60:170-178, 1962. 24. Ervasti J: Primary carcinoma of the liver . Acta Chir Scand [Suppl] 334, 1964. 25. Murray-Lyon IM, et al: Treatment of secondary hepatic tumours by ligation of hepatic artery and infusion of cytotoxic drugs . Lancet 2:172-175, 1970.Crossref 26. Lin TY: Primary cancer of the liver . Scand J Gastroenterol 5:223-241, 1970. 27. Longmire WP Jr, Sandford MC: Intrahepatic cholangiojejunostomy with partial hepatectomy for biliary obstruction . Surgery 24:264-276, 1948. 28. Zieve L: Pathogenesis of hepatic coma . Arch Intern Med 118:211-223, 1966.Crossref 29. Bengmark S, et al: A twostage liver resection combined with long-term intraportal 5-Fu infusion. Rev Surg, to be published. 30. Hafström LO, Zettergren L, Åkesson L-Ä: The natural history of primary and secondary malignant tumours of the liver: IV. The prognosis for patients with carcinoma of the gallbladder, with special reference to the amount of tumour growth within the liver at time of diagnosis . Acta Chir Scand 139:264-269, 1973.

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1974

References