Liver Abscess Formation Following Transarterial Chemoembolization

Lv, Wei‐Fu; Lu, Dong; He, Yusheng; Xiao, Jianghong; Zhou, Chunze; Cheng, Delei

doi:10.1097/md.0000000000003503

Cited by 45 publications

(29 citation statements)

References 16 publications

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“…[11] The present study suggested that the most frequently reported symptom was pain, followed by fever, however, which were also frequently encountered in patients without major complications. Contrast-enhanced CT, MRI, and abdominal ultrasonography are useful to differentiate major complications formation from tumor necrosis syndrome.…”

Section: Discussionmentioning

confidence: 57%

“…The early diagnosis and therapeutic strategies for major complications following TAE/TACE therapy have been reported differently due to individual patients’ critical pathophysiological status, such as advanced tumors, hepatic dysfunction, ascites, and dyscrasia. [11] The present study suggested that the mortality rate of major complication following TAE/TACE was 16.7%.…”

Section: Discussionmentioning

confidence: 61%

“…[9,18] The risk factors of liver abscess are bacterial infection superimposed upon liver embolization and necrosis; infection during the TACE procedure, the immunosuppressant effect of chemotherapeutic agents leading to decreased immunity, patients who have diabetes mellitus, and history of bilioenteric anastomosis. [11] The risk factors of femoral artery pseudoaneurysm are atherosclerosis and hypertension. The risk factors of pulmonary oil or thrombus embolism are arteriovenous shunt, long time of lying in bed following TAE/TACE, and compression of the femoral vein.…”

Section: Discussionmentioning

confidence: 99%

“…[11] The management strategies for major complications following TAE/TACE therapy are various and dependent on major complication itself and patient's condition. Although initial conservative treatment should be carried out immediately for most patients after the occurrences of major complications; some major complications need treatment interventions, like TAE in the treatment of liver rupture, surgery in the treatment of gallbladder perforation, and percutaneous drainage in the treatment of liver abscess or biloma.…”

Section: Discussionmentioning

confidence: 99%

“…[7,9,11] However, the incidence and outcome are largely unknown. [9] The aim of this study was to investigate the incidence and outcome of major complication following conventional TAE/TACE in patients with HCC.…”

Section: Introductionmentioning

confidence: 99%

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The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma

Jia

Xiao

et al. 2016

Medicine

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To investigate the incidence and outcome of major complication following conventional transarterial embolization/chemoembolization (TAE/TACE) therapy for hepatocellular carcinoma (HCC).From May 2010 to May 2016, all patients with major complication following conventional TAE/TACE for HCC were included. Major complication was defined as admission to a hospital for therapy, an unplanned increase in the level of care, prolonged hospitalization, permanent adverse sequelae, or death after conventional TAE/TACE therapy by Society of Interventional Radiology.During the study period, a total of 2863 TAE/TACE procedures were performed among 1120 patients, and a total of 24 patients (21 male and 3 female) developed major complication with the incidence of 2.1% (24/1120) per patient and 0.84% (24/2863) per TAE/TACE procedure. The major complications were liver rupture (n = 6), liver abscess (n = 5), femoral artery pseudoaneurysm (n = 3), cholecystitis (n = 2), biloma (n = 2), pulmonary embolism (n = 2), and 1 each of the following: cerebral lipiodol embolism, tumor lysis syndrome, partial intestinal obstruction, gallbladder perforation. The mean interval from last TAE/TACE procedure to the diagnosis of major complication was 11.1 ± 7.7 days. The treatments of the complications were conservative treatment (n = 12), conservative treatment plus percutaneous drainage (n = 3), ultrasound-guided thrombin injection (n = 3), conservative treatment plus TAE (n = 2), and conservative treatment plus surgery (n = 2). Of the 24 patients, 20 patients were recovered, and remaining 4 patients were died of major complications; therefore, the mortality rate of major complication was 16.7% (4/24).Major complication following conventional TAE/TACE therapy is uncommon; the outcomes are benign of most major complications, but some are mortality.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma

Jia

Xiao

et al. 2016

Medicine

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Hepatic abscess induced by gastric cancer mimicking differentiated hepatocellular carcinoma

Kishimoto,

Morita,

Yazumi

2023

JGH Open

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A 58‐year‐old man was referred to our hospital with right abdominal pain. Contrast‐enhanced computed tomography (CECT) showed a rim‐enhanced lesion with a fluid collection in the right hepatic lobe. Upper gastrointestinal endoscopy revealed a Borrmann type 1 tumor on the middle gastric body, identified as an adenocarcinoma on pathology. The patient underwent percutaneous transhepatic abscess drainage and was treated with antibiotics. Two weeks after drainage, CECT revealed shrinkage of the abscess; however, the wall showed contrast enhancement. Needle biopsy was performed for the liver tumor, and it suggested the possibility of highly differentiated hepatocellular carcinoma. The patient first underwent gastrectomy, and the liver tumor was followed with CECT. Two months after surgery, CECT revealed that the liver tumor had vanished. Liver abscesses and infectious tumors can be difficult to differentiate between; therefore, careful scrutiny is essential before treatment.

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Pyogenic liver abscess in non‐liver cancer patients and liver cancer patients treated with TACE: Etiological characteristics, treatment, and outcome analysis

Liu

Ren

Song

et al. 2022

The Kaohsiung J of Med Scie

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Background: The purpose of this study was to evaluate the clinical, laboratory and microbiological features, clinical outcomes, and prognosis of pyogenic liver abscess (PLA) in non-liver cancer (Non-LC) patients and liver cancer patients treated with transarterial chemoembolization (TACE, LC-TACE).Methods: Clinical data of 48 consecutive PLA patients from January 2016 to December 2020 were retrospectively analyzed. The mortality was compared between the two groups of PLA patients, and risk factors for mortality were evaluated.Results: A total of 48 PLA patients meeting the inclusion criteria were included in this study from January 2016 to December 2020, including 31 males and 17 females. Among them, there were 32 patients in the Non-LC group and 16 patients in the LC-TACE group. Fever and chills were the most common symptoms in both groups, followed by abdominal pain. Shock occurred in 2 patient in the Non-LC group and 3 patients in the LC-TACE group. The positive rate of pus culture in the Non-LC group was 87.5%, among which the most common pathogen was Klebsiella pneumoniae (50%, 14/28), and the positive rate of pus culture in the LC-TACE group was 81.3%, among which the most common pathogen was Escherichia coli (30.8%, 4/13). In the Non-LC group, 28 patients improved after treatment, 1 patient did not improve, and 3 patients died during hospitalization, with a mortality rate of 9.4%. In the LC-TACE group, 9 cases improved after treatment, 3 cases did not improve, and 4 cases died during hospitalization, with a mortality rate of 25%. Multivariate analysis revealed no independent prognostic factor associated with mortality. The cure time of the Non-LC group was 37.4±23.1 days (6-90 days), while that of the LC-TACE group was 91.5±49.7 days (19-180 days), with a statistically signi cant difference between the two groups (P < 0.001).Conclusions: PLA of the Non-LC group and the LC-TACE group were different in terms of pathogenic bacteria and cure time, etc. For PLA after TACE, a more aggressive and comprehensive treatment should be considered.

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Liver Abscess Formation Following Transarterial Chemoembolization

Cited by 45 publications

References 16 publications

The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma

The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma

Hepatic abscess induced by gastric cancer mimicking differentiated hepatocellular carcinoma

Pyogenic liver abscess in non‐liver cancer patients and liver cancer patients treated with TACE: Etiological characteristics, treatment, and outcome analysis

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