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Hepatic artery embolisation for carcinoid

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This page has information about hepatic artery embolisation for carcinoid (neuroendocrine) tumours that have spread to the liver.

 

A quick guide to what's on this page

Hepatic embolisation for carcinoid

Hepatic embolisation aims to block the blood supply to the carcinoid tumour in the liver. The tumour can’t survive without a blood supply. Blocking the blood supply also stops the tumour releasing its hormones into the blood system. Your doctor may give chemotherapy directly into the liver at the same (called chemoembolisation). 

Your doctor may recommend hepatic embolisation if

  • You have a carcinoid tumour that has only spread to your liver
  • You can’t have surgery to remove the liver tumour
  • Your tumour is producing a lot of hormones
  • Other drug treatments have not controlled your carcinoid symptoms
  • You have one main tumour in the liver rather than several small ones

How you have hepatic artery embolisation

You usually have this treatment under sedation. Your doctor makes a small cut (incision) into your groin and gently pushes a thin tube into the main blood vessel (the femoral artery). Watching on a scan, the doctor then guides the tube into the main blood vessel of the liver, the hepatic artery. 

The doctor injects a substance to block the blood supply, such as a gel or tiny beads. They may give chemotherapy into the liver beforehand. Or they may add beads that are loaded with chemotherapy. 

After the treatment you usually need to stay in hospital for 1 or 2 nights.

Side effects of hepatic embolisation

The side effects of this treatment include flu-like symptoms, feeling sick, feeling hot, and pain around your liver or shoulders. The effects usually last for a few days. Rarely, some people have more serious side effects such as an infection, a liver abscess, kidney damage or liver failure.

 

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What hepatic embolisation is

Hepatic arterial embolisation (HAE) aims to block the blood supply to the carcinoid tumour in the liver. The tumour can’t survive without a blood supply. Blocking the blood supply also stops the tumour releasing its hormones into the blood system. Doctors may give a chemotherapy drug directly to the liver at the same time. This is called chemoembolisation or trans arterial chemoembolisation (TACE).

 

Hepatic embolisation for carcinoid

Your doctor may recommend hepatic embolisation if

  • You have a carcinoid tumour that has only spread to your liver
  • You can’t have surgery to remove the liver tumour
  • Your tumour is producing a lot of hormones
  • Other drug treatments have not controlled your carcinoid symptoms
  • There is one main tumour rather than several small ones

Hepatic embolisation can help shrink carcinoid tumours in the liver and also reduces the amount of hormones the tumour makes. It helps to control symptoms for most people. You can have the same treatment again when the tumour grows back.

 

Having hepatic embolisation treatment

You have this treatment in the X-ray (radiology) department of the hospital. The doctor who does this procedure is called an interventional radiologist.

You cannot eat for 4 hours before the procedure, but you can usually drink water for up to 2 hours beforehand.

Your doctor puts a drug (sedation) into a small tube in your arm (cannula) to make you drowsy and relaxed. They then inject a local anaesthetic into your groin to numb the area. Once the area is numb, they make a small cut (incision) into your groin and gently push a thin tube into the main blood vessel (the femoral artery).

Watching on a scan, the doctor then guides the tube into the main blood vessel of the liver, the hepatic artery. They inject a substance, such as a gel or tiny beads, to block the blood vessels. They may put a chemotherapy drug into the tube first. Or they may inject tiny beads that are already loaded with chemotherapy. 

You have to lay flat for about 4 hours after the procedure. This is to reduce the risk of bleeding from the femoral artery. 

You usually stay in hospital for 1 or 2 nights after the treatment.

 

Side effects of hepatic embolisation

The side effects of hepatic embolisation include

  • Flu-like symptoms
  • Feeling sick
  • Feeling hot
  • Pain around your liver (the upper right side of your abdomen) or shoulders

Side effects usually last for a few days after you’ve had the treatment. Your doctor can give you anti sickness drugs and painkillers if you need them. 

Tiredness (fatigue) is a common side effect and usually lasts around 2 weeks.

Rarely, some people have more serious side effects from this treatment, for example

  • Infection or a liver abcess - you will have antibiotics before and after the procedure to reduce this risk
  • Bleeding - your doctor and nurses will monitor you regularly so if this does happen they can deal with it straight away
  • Kidney damage - you may have fluids through a drip before the procedure to reduce this risk
  • Liver failure - you have blood tests before and after the procedure to check how well your liver and kidneys are working
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Updated: 25 June 2016