Liver Abscess after Transcatheter Oily Chemoembolization for Hepatic Tumors: Incidence, Predisposing Factors, and Clinical Outcome
Autor: | Jin Wook Chung, Young Hwan Koh, Jae Hyung Park, Hyung Guhn Lim, Hyo-Suk Lee, Soon-Young Song, Chung Yong Kim, Joon Koo Han |
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Rok vydání: | 2001 |
Předmět: |
Male
medicine.medical_specialty Percutaneous medicine.medical_treatment Liver Abscess Constriction Pathologic medicine Humans Radiology Nuclear Medicine and imaging Embolization Chemoembolization Therapeutic Abscess Retrospective Studies Cholestasis Portal Vein business.industry Incidence Incidence (epidemiology) Liver Neoplasms Iodized Oil Retrospective cohort study Middle Aged medicine.disease Anti-Bacterial Agents Surgery Causality Treatment Outcome Doxorubicin Case-Control Studies Hepatocellular carcinoma Multivariate Analysis Drainage Female Liver function Cardiology and Cardiovascular Medicine business Liver abscess |
Zdroj: | Journal of Vascular and Interventional Radiology. 12:313-320 |
ISSN: | 1051-0443 |
DOI: | 10.1016/s1051-0443(07)61910-1 |
Popis: | PURPOSE To evaluate the incidence of, predisposing factors for, and clinical outcome of liver abscess developing in patients with hepatic tumors after transcatheter oily chemoembolization (TOCE). MATERIALS AND METHODS During the past 6-year period, 2,439 patients with hepatic tumors underwent a total of 6,255 TOCE procedures. With a retrospective review of medical records, the authors evaluated the occurrence of liver abscess, the statistical significance of potential predisposing factors including portal vein obstruction, metastatic tumors, biliary abnormalities (type 1, simple biliary obstruction; type 2, status prone to ascending biliary infection), malignant gastrointestinal mucosal lesions, and additional gelatin sponge particle embolization in liver abscess formation, and the clinical outcome of abscess. RESULTS Fifteen liver abscesses occurred in 14 patients (0.2%). Liver abscesses developed in three of 987 (0.3%) TOCE procedures for portal vein obstruction, 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 abnormality, two of 18 (11.1%) for malignant gastrointestinal mucosal lesion, and nine of 2,108 (0.4%) for additional gelatin sponge particle embolization. Univariate and multivariate statistical analysis showed that type 2 biliary abnormality was a significant predisposing factor. The mortality related to liver abscess occurred in two patients (13.3%). Thirteen liver abscesses were successfully treated with parenteral antibiotics and percutaneous catheter drainage. However, irreversible deterioration of liver function occurred in two patients. Two of nine further TOCE procedures in three patients caused recurrent septicemia and liver abscess. CONCLUSION The biliary abnormality prone to ascending biliary infection was the most important predisposing factor to the development of liver abscess after TOCE. Postembolic liver abscess could be effectively managed with percutaneous catheter drainage. |
Databáze: | OpenAIRE |
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