Risk factors of liver abscess and biloma formation after drug-eluting bead transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma

Longhao Bian; Jianjun Yang; Zhaomin Song

doi:10.1016/j.ajg.2024.01.012

Risk factors of liver abscess and biloma formation after drug-eluting bead transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma

Arab J Gastroenterol. 2024 Feb 21:S1687-1979(24)00012-1. doi: 10.1016/j.ajg.2024.01.012. Online ahead of print.

Authors

Longhao Bian¹, Jianjun Yang¹, Zhaomin Song²

Affiliations

¹ Department of Interventional Treatment, Third Hospital of Qinhuangdao, No.222 Jianguo Road, Qinhuangdao, Hebei Province, China.
² Department of Interventional Treatment, Third Hospital of Qinhuangdao, No.222 Jianguo Road, Qinhuangdao, Hebei Province, China. Electronic address: songzmray@163.com.

PMID: 38388217
DOI: 10.1016/j.ajg.2024.01.012

Abstract

Background and study aims: Drug-eluting bead transarterial chemoembolization (DEB-TACE) causes serious complications, including liver abscess and biloma formation. This study aimed to investigate the frequency and risk factors of liver abscess and biloma formation after dug-eluting bead transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma (ICC).

Patients and methods: 152 unresectable ICC patients received 241 DEB-TACE procedures from February 2018 to November 2022 were studied retrospectively. Patients were evaluated for the presence of liver abscess and biloma formation after DEB-TACE. The medical records, including baseline demographic data, preoperative imaging data, DEB-TACE details, and postoperative management, were reviewed to search for risk factors of liver abscess and biloma formation.

Results: Liver abscesses developed in 11 cases, with an incidence rate of 7.2 % (11/152) per patient and 4.6 % (11/241) per procedure. In the 11 patients with abscesses, the incidence of biloma formation was 36.4 % (n = 4). The binary logistic regression analysis showed that diabetes mellitus (OR 7.967, 95 % CI 1.491-42.571, p = 0.015), bilioenterostomy or biliary stent implantation (OR 18.716, 95 % CI 1.006-348.049, p = 0.049) and grade 1 arterial occlusion (OR 9.712, 95 % CI 1.054-89.484, p = 0.045) were independent risk factors for liver abscess and biloma formation.

Conclusion: Liver abscesses and biloma formation induced by DEB-TACE are associated with various factors. Diabetes mellitus, bilioenterostomy or biliary stent implantation, and grade 1 artery occlusion were all associated with liver abscess and biloma formation after DEB-TACE for unresectable ICC. In patients with these risk factors, the DEB-TACE procedure should be finely designed and manipulated with more caution.

Keywords: DEB-TACE; Intrahepatic cholangiocarcinoma; Liver abscess.