Hepatic Arterial Ligation with and Without Portal Infusion in Metastatic Colorectal Cancer

If liver metastases are diffuse and spread out in both lobes of the liver, the question is: Which treatment should be given? Until now, no therapy has been proven to increase the survival rate of patients with these diffuse metastases. Liver tumors are irrigated mainly by arterial supply. Indeed, the blood flow of liver metastases decreases by 90% in the tumor after hepatic artery ligation. Under the same conditions, it decreases by only 35% in normal liver parenchyma. Unfortunately, the decrease in arterial flow in the liver after interruption of the blood supply is temporary. Within 3 weeks, a revascularization is visible through the lesser omentum and the greater omentum, as well as through the celiac axis and the inferior phrenic artery.