The complications of<unk>  therapy can be divided into those related to the surgical placement of the pump, technical catheter-related complications, and those related to the chemotherapeutic agents used. Relating to the surgical<unk>  pump placement, early postoperative complications consist of<unk>  injury leading to hepatic artery thrombosis, inadequate perfusion of the entire liver due to the inability to identify an accessory hepatic artery, extrahepatic perfusion to the stomach or duodenum, or hematoma formation in the subcutaneous pump pocket. Late complications are more common and include inflammation or ulceration of the stomach or duodenum, and pump pocket infection. The most common catheter related complications include displacement of the catheter, occlusion of the hepatic artery because of the catheter, and catheter thrombosis. These catheter related complications don't occur as frequently with increased surgical experience and with improvements in pump design. The most common toxicities caused by the chemotherapeutic agents were gastrointestinal symptoms, chemical hepatitis, and bone marrow inhibition. It is important to note that the most serious and dose limiting complication of<unk>  is hepatobiliary toxicity. This occurs more commonly with FUDR than any other chemotherapeutic agent. Patients undergoing<unk>  therapy therefore have regular liver function tests to monitor any damage to the liver. As previously mentioned, studies have been carried out to come up with treatment algorithms to minimize this serious side effect. It has been shown that adding leucovorin and FUDR for infusion through the pump not only reduces the biliary toxicity of the drug, but also increases the response rate. However, biliary sclerosis is not seen with<unk>  using 5-FU. 5-FU is associated with an increased risk of myelosuppression. Logically, it would make sense to therefore consider alternating between<unk>  FUDR and<unk>  5-FU.
Hepatic arterial infusion
Percutaneous hepatic perfusion
Isolated hepatic perfusion
Peritoneovenous shunt
Continuous hyperthermic peritoneal perfusion
Perihepatic packing
Hepatic artery embolization
Intraosseous infusion