Investigation of bile duct injury after transcatheter arterial chemoembolization.
- Author:
Mao-qiang WANG
1
;
Ru-hong SHAO
;
Hui-yi YE
;
Zhi-qiang WANG
;
Zhong-pu WANG
;
Feng-yong LIU
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; administration & dosage; adverse effects; Bile Ducts; diagnostic imaging; pathology; Carcinoma, Hepatocellular; therapy; Chemoembolization, Therapeutic; adverse effects; Cholangiography; Cisplatin; administration & dosage; Dilatation, Pathologic; etiology; Epirubicin; administration & dosage; Female; Fluorouracil; administration & dosage; Follow-Up Studies; Humans; Iodized Oil; administration & dosage; Liver Neoplasms; therapy; Magnetic Resonance Imaging; Male; Middle Aged; Mitomycin; administration & dosage; Ultrasonography
- From: Chinese Journal of Oncology 2005;27(10):609-612
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the image findings of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatic malignancy.
METHODSDuring the past 3 years, 1240 patients with different hepatic malignancies had undergone a total of 2680 TACE procedures. Eighteen patients (1.4%) developed bile duct injuries from 3 weeks to 3 months after TACE. All of the 18 patients received follow-up CT and ultra-sonography, 14 MRI and 15 digital subtract angiography (DSA). The image data was retrospectively reviewed, with the potential predisposing factors correlated to TACE-induced bile duct injury.
RESULTSTACE-induced bile duct injuries developed in 13 of 148 patients with liver metastasis (8.8%), 5 of 1092 patients with hepatocellular carcinoma (HCC) (0.5%). On image examination, focal peripheral intrahepatic bile duct dilatation was detected in 4 cases, multiple bile duct dilatations with segmental or sub-segmental distribution in 8, and a large lobular cystic lesion or biloma in 6 cases, and progressive atrophy of the corresponding hepatic parenchyma in 6 patients in whom the TACE induced-bile injury developed at different intervals after TACE. The incidence of bile duct injury was higher in non-cirrhotic patients with metastatic liver lesions than in patients with hepatocellular carcinoma associated with cirrhosis (P < 0.01), and it was also higher in patients using an emulsion of lipiodol-cisplatin or carboplatin than in patients using other emboliging agents (P < 0.01). The incidence was higher either in patients with hypovascular lesions than in patients with hypervascular lesions (P < 0.05).
CONCLUSIONBiliary abnormalities, including focal and multiple intrahepatic bile duct dilatation, and cystic lesion or biloma, may develop and can be detected during the follow-up examination imaging in patients with hepatic malignancy after TACE. Noncirrhotic liver and intact function, due to the lack of peri-biliany collateral circulation, are the significant predisposing factors to the development of TACE-induced bile duct injury.
