Acute necrotizing pancreatitis after transarterial chemoembolization of hepatocellular carcinoma: an usual complication

Alcívar-Vásquez, Juan; Ontanilla-Clavijo, Guillermo; Ferrer-Ríos, María Teresa; Pascasio-Acevedo, Juan Manuel

doi:10.4321/s1130-01082014000200014

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…It occurs in ~1.7-2% of all patients following selective and superselective liver tumor embolization (6). This complication results from a retrograde injection of the chemotherapeutic, embolizing agent into the pancreatic arteries, giving rise to ischemic pancreatitis (8). To prevent this complication, it is important to reduce the backflow of embolic material by placing the catheter tip as close to the distal branches of the hepatic artery as possible, and embolic materials should be injected carefully to avoid regurgitation (7).…”

Section: Discussionmentioning

confidence: 99%

“…Rarely, extrahepatic organs may incur ischemic damage, such as acute cholecystitis (2), necrosis of the epigastric skin (3), interstitial pneumonitis (4), gastrointestinal tract ulceration (5) and acute pancreatitis (6)(7)(8)(9). The proposed mechanism underlying these complications is inadvertent embolization through the collateral vessels or regurgitation of the chemotherapeutic agent into the arteries of other organs.…”

Section: Introductionmentioning

confidence: 99%

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Acute necrotizing pancreatitis as a fatal complication�following DC Bead transcatheter arterial chemoembolization for hepatocellular carcinoma: A case report and review of the literature

et al. 2018

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Transcatheter arterial chemoembolization (TACE) is one of the most effective palliative measures for patients with inoperable hepatocellular carcinoma (HCC). Acute pancreatitis is a rare but well-known complication following TACE. We herein present the case of a patient with HCC who developed fatal complications (acute necrotizing pancreatitis and upper gastrointestinal ulcers) after TACE with DC Beads. The patient was diagnosed with HCC in segments 4 and 8, measuring ~70 mm in greatest diameter, and he was treated by TACE. Hepatic arteriography revealed replacement of the origin of the right hepatic artery to the superior mesenteric artery, while the left hepatic artery originated from the celiac artery. After selection of the segmental arterial branches feeding the tumor, 2 ml of 100-300-µm-sized DC Beads loaded with 150 mg epirubicin were injected through the microcatheter. The patient complained of abdominal pain after the TACE procedure. Upper gastrointestinal endoscopy revealed longitudinal ulcers from the esophagus to the duodenum, and contrast-enhanced computed tomography revealed swelling of the pancreas and focal areas of low density in the pancreatic body, suggesting necrosis. The patient developed respiratory insufficiency, renal failure and sepsis, and finally succumbed to the complications 54 days after the procedure, despite general management of the acute pancreatitis. An autopsy revealed that the main cause of the patient's death was extensive pancreatic necrosis due to a gastroduodenal artery embolism after TACE with DC Beads. Therefore, it is crucial for treating physicians to be aware of this complication following TACE with DC Beads, particularly in patients with anatomical variations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute necrotizing pancreatitis as a fatal complication�following DC Bead transcatheter arterial chemoembolization for hepatocellular carcinoma: A case report and review of the literature

et al. 2018

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“…Acute pancreatitis can develop within 24 hours to up to 15 days after TACE procedure (6,7). The severity can range from mild (4) to necrotizing pancreatitis (6)(7)(8)(9)(10)(11)(12). In the largest study by López-Benítez et al, evaluating risk factors for acute pancreatitis following liver embolization (bland or chemotherapeutic), volume of embolic microspheres and use of carboplatin were most significantly associated with TACE induced pancreatitis (4).…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis as a complication of trans-arterial chemoembolization of hepatocellular cancer—case report and review of literature

Krishnamurthy

Brown

Agrawal

et al. 2017

J. Gastrointest. Oncol.

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Transarterial chemoembolization (TACE) is a therapeutic procedure often performed for hepatocellular carcinoma (HCC). Local complications, though generally uncommon, can arise from arterial ischemia and local cytotoxicity from the chemotherapeutic delivery. We present a case of acute pancreatitis as a rare complication of the TACE procedure along with a review of literature of this uncommon adverse effect.

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“…Pancreatitis after transarterial embolization for the treatment of hepatocellular carcinoma results from a retrograde injection of the chemotherapeutic or embolic agents into pancreatic arteries, giving rise to ischemic pancreatitis [36].…”

Section: Postoperative Pancreatitismentioning

confidence: 99%

Etiology of Pancreatitis and Risk Factors

Lauret¹,

Rodríguez-Peláez²,

Sáez³

2015

Acute and Chronic Pancreatitis

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Acute necrotizing pancreatitis after transarterial chemoembolization of hepatocellular carcinoma: an usual complication

Cited by 8 publications

References 6 publications

Acute necrotizing pancreatitis as a fatal complication�following DC Bead transcatheter arterial chemoembolization for hepatocellular carcinoma: A case report and review of the literature

Acute necrotizing pancreatitis as a fatal complication�following DC Bead transcatheter arterial chemoembolization for hepatocellular carcinoma: A case report and review of the literature

Acute pancreatitis as a complication of trans-arterial chemoembolization of hepatocellular cancer—case report and review of literature

Etiology of Pancreatitis and Risk Factors

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