Early Implementation of a Hepatic Artery Infusion Pump Program in a Contemporary Multi-Hospital Health System: Integration With Minimally Invasive and Combined Surgical Strategies for Colorectal Liver Metastases

Hepatic artery infusion pump (HAIP) therapy has re-emerged as an important liver-directed treatment for colorectal liver metastases (CRLM), yet its integration into contemporary surgical workflows, including minimally invasive and combined procedures, remains incompletely characterized. We performed a retrospective analysis of patients undergoing HAIP placement between 2022 and 2024 at a multi-hospital academic health system. Nine patients were identified, including four who underwent synchronous colectomy. Operative time and length of stay were longer in synchronous cases (10h51min vs 8h56min; 7.0 vs 3.5 days), while a minimally invasive approach was utilized in 78% of cases and hepatectomy in two-thirds. No 30-day mortality or infectious complications were observed, and one Clavien-Dindo grade III complication occurred. This early implementation-focused experience demonstrates how HAIP therapy can be operationalized within a contemporary multi-hospital system through multidisciplinary patient selection, integration with minimally invasive surgery, and coordination of combined colorectal and liver procedures. These findings provide practical insights for centers seeking to develop similar HAIP programs.