Treatment of GI Tumours – Hepatic Embolisation (3)	

The blood supply of the normal liver arises from the hepatic artery and the portal vein. Hepatic metastases, which are supplied only by the hepatic artery, can be devascularised by embolisation of the hepatic arterial tree (Figs. 19.27–19.29) without affecting normal liver parenchyma, providing that the portal vein is patent. Hepatic embolisation can provide good palliation in over fifty per cent of patients with symptomatic hepatic metastases, and the procedure can be repeated when symptoms recur. The somatostatin analogue octreotide should be administered to counter the effects of massive hormone release following embolisation, and broad-spectrum antibiotic prophylaxis is recommended.