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Percutaneous Ethanol Injection (PEI) For Liver Cancer


The word “cancer” evokes a particularly deep-rooted set of fears, especially when located in a crucial organ such as the liver. As upsetting as a diagnosis can be, patients should be aware that new and increasingly effective treatments have been developed over the last few decades and more continue to be researched. Percutaneous Ethanol Injection (PEI), in certain cases, can be a powerful alternative to chemotherapy or radiation treatment in fighting liver cancer.

What is it?

PEI describes the procedure in which completely sterile, pure alcohol is injected directly into the cancerous liver cells via an ultrathin needle. The alcohol kills tumors by drawing water out of the cells and rapidly dehydrating them. Although it may take several sessions to kill a tumor, the process is fairly effective in the case of small, well-defined tumors.

How is the procedure carried out?

A doctor will target the location of the liver tumor(s) using either CT visual guidance or an ultrasound. Over the course of five or six sessions, the doctor will inject the pure alcohol into the tumors. Sessions can be performed once or twice a week in most cases. Patients typically can use local anesthesia for this procedure, but may require general if they have multiple tumors.

Risks and benefits?

PEI sidesteps many of the more painful symptoms of chemotherapy. For relatively small, easy-to-target tumors this process can be extremely effective. It typically costs significantly less than surgery, chemotherapy or radiation treatment.

It is not, however, without its detriments and side effects. Leakage of alcohol onto the surface of the liver is a common side effect. This causes fevers and sometimes acute pain. It is also possible to cause bile leakage, bleeding or bile duct inflammation when administering this treatment.

Is it for you?

Patients with severely damaged livers or any signs of chronic liver failure should avoid this procedure. It is also important to note that this procedure only works well with tumors that are less than 3 cm in diameter and have clearly defined margins. Tumors that have broken apart or begun to spread may be difficult or even impossible to target and eliminate effectively. It is also not practical for patients who have many tumors.

Generally speaking, this procedure is reserved for primary liver cancers that are still in their early developmental stages. It has been tried against secondary cancers, or liver metastases, but with a lower rate of success. If you are fortunate enough to detect liver cancer early on, talk to your doctor about trying PEI instead of chemotherapy or radiation. PEI is also often used in cases where doctors might otherwise resort to surgery.


  1. Percutaneous Ethanol Injection: Facts on Liver Treatment. Available from Accessed on May 11, 2015.

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