Hepatic dearterialization for carcinoid syndrome due to liver metastases

The cases are described of three patients with a carcinoid syndrome resulting from hepatic metastases of a carcinoid in the distal ileal tract. Treatment consisted in resection of the primary tumor and of the regional lymph-node metastases, combined with dearterialization of the liver. Apart from rapidly transient disorders of hepatic function, no postoperative complications occurred. Dearterialization should be regarded as a palliative operation and would appear to be beneficial. Optimally effective dearterialization may be achieved with the aid of peroperative angiography after the standard procedure. This will reveal any collaterals and anatomical variants that remain to be occluded. Postoperative mitigation of symptoms is the best parameter for evaluation of the efficacy of the dearterialization.