Liver abscess after transcatheter oily chemoembolization for hepatic tumors: Incidence, predisposing factors, and clinical outcome

Citation
Sy. Song et al., Liver abscess after transcatheter oily chemoembolization for hepatic tumors: Incidence, predisposing factors, and clinical outcome, J VAS INT R, 12(3), 2001, pp. 313-320
Citations number
25
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging
Journal title
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN journal
1051-0443 → ACNP
Volume
12
Issue
3
Year of publication
2001
Pages
313 - 320
Database
ISI
SICI code
1051-0443(200103)12:3<313:LAATOC>2.0.ZU;2-K
Abstract
PURPOSE: To evaluate the incidence of, predisposing factors for, and clinic al outcome of liver abscess developing in patients with hepatic tumors afte r transcatheter oily chemoembolization (TOCE). MATERIALS AND METHODS: During the past 6-year period, 2,439 patients with h epatic tumors underwent a total of 6,255 TOCE procedures. With a retrospect ive review of medical records, the authors evaluated the occurrence of live r abscess, the statistical significance of potential predisposing factors i ncluding portal vein obstruction, metastatic tumors, biliary abnormalities (type 1, simple biliary obstruction; type 2, status prone to ascending bili ary infection), malignant gastrointestinal mucosal lesions, and additional gelatin sponge particle embolization in liver abscess formation, and the cl inical outcome of abscess. RESULTS: Fifteen liver abscesses occurred in 14 patients (0.2%). Liver absc esses developed in three of 987 (0.3%) TOCE procedures for portal vein obst ruction, three of 114 (2.6%) procedures for metastatic tumors, one of 49 (1 .8%) for type 1 biliary abnormality, four of 55 (7.4%) for type 2 biliary a bnormality, two of 18 (11.1%) for malignant gastrointestinal mucosal lesion , and nine of 2,108 (0.4%) for additional gelatin sponge particle embolizat ion. Univariate and multivariate statistical analysis showed that type 2 bi liary abnormality was a significant predisposing factor. The mortality rela ted to liver abscess occurred in two patients (13.3%). Thirteen liver absce sses were successfully treated with parenteral antibiotics and percutaneous catheter drainage. However, irreversible deterioration of liver function o ccurred in two patients. Two of nine further TOCE procedures in three patie nts caused recurrent septicemia and liver abscess. CONCLUSION: The biliary abnormality prone to ascending biliary infection wa s the most important predisposing fatter to the development of liver absces s after TOCE. Postembolic liver abscess could be effectively managed with p ercutaneous catheter drainage.