Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Naumann, Michael; Gupta, Ramona

doi:10.1055/s-0031-1280667

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…13 Furthermore, the total amount of iodized oil, chemotherapeutic agents, microspheres, gelfoam, and drug-eluting beads are reported as other risk factors. [13][14][15] In this case report, repeated RFA and TACE might have a role for the development of bile duct complications (multiple severe biloma and bile duct stricture).…”

Section: Discussionmentioning

confidence: 76%

“…Moreover, repeated treatment of TACE is also considered important risk factors to bile duct complications. 1,[13][14][15] This is because recurrent vasculitis and repeated thrombosis caused by repeated TACE may predispose the bile ducts to ischemic insult. 13 Furthermore, the total amount of iodized oil, chemotherapeutic agents, microspheres, gelfoam, and drug-eluting beads are reported as other risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Biliary complications after transcatheter arterial chemoembolization for hepatocellular carcinoma

Lee

Kim

2020

Int J Gastrointest Interv

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Transarterial chemoembolization (TACE) is considered an effective procedure for liver malignancy. Although the majority of TACE related complications can be treated conservatively, appropriate therapeutic interventions, such as percutaneous/endoscopic drainage or partial hepatectomy, might be needed in cases of signs of severe infection and/or progressive biloma. Therefore, we herein report a case of TACE induced biliary complications which were treated with a multidisciplinary approach; intrahepatic progressive biloma was treated with percutaneous drainage, intrahepatic bile duct stricture was treated by endoscopic balloon dilation and plastic stent placement.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Biliary complications after transcatheter arterial chemoembolization for hepatocellular carcinoma

Lee

Kim

2020

Int J Gastrointest Interv

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“…The normal liver tissue is a double blood supply, of which 75% of the blood is supplied by the portal vein and the other 20% is supplied by the hepatic artery ( 13 ). However, 95% of the blood perfusion of liver cancer is directly derived from the hepatic artery ( 14 ). Blood from the hepatic artery primarily supplies the central region of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Effect of curcumin-lipiodol emulsion combined with absorbable anti-adhesion film through double embolic pathway on angiogenesis and overall survival (OS) time of VX2 liver cancer rabbits

Yang¹,

Xu²,

Nie³

et al. 2020

Transl Cancer Res TCR

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Background: Curcumin is a promising anti-tumor drug in recent years. The main function of absorbable anti-adhesion film is to prevent adhesions after surgical operation. The effects of curcumin-lipiodol emulsion injected via the hepatic artery and portal vein catheter combined with using absorbable anti-adhesion film around the liver angiogenesis are unknown. This article mainly discusses the effects of these combined strategies on the inhibition or reduction of postoperative angiogenesis and prolonging survival time of rabbit model.Methods: Forty model rabbits with VX2 liver cancer were divided into four groups. Group A is the control group and its intervention is a simple lipiodol emulsion group. The intervention in group B was a simple lipiodol emulsion combined with an anti-adhesion membrane. The intervention in group C was a mixture of curcumin and lipiodol. The intervention in group D was a mixed emulsion of curcumin and lipiodol combined with an anti-adhesion membrane. The levels of aspartate aminotransferase (ALT) and alanine aminotransferase (AST) in the model rabbits were compared to analyze the damage of liver cells 1 day before embolization and 3, 7, 14 days after the embolization. In addition, the levels of vascular endothelial growth factor (VEGF) and microvessel density (MVD) in residual cancer tissues were determined by immunohistochemistry and Western blot. Finally, overall survival time (OS) of each group was recorded. Results:The results showed that the ALT and AST levels of venous blood before and after embolization in each group of rabbits were not changed significantly (P>0.05). The levels of VEGF and MVD in the group C and group D were lower than those in the group A (P<0.05). However, there was no significant difference between group B and group A (P>0.05). The decrease of VEGF and MVD in group D was most obvious, and group D had a significant difference compared with group C (P<0.05). Western blot analysis showed that the protein expression of VEGF was consistent with immunohistochemical staining. The overall survival (OS) time of group B showed no significant difference compared with group A (P>0.05). The OS time of group C and group D was longer than that of group A (P<0.05). Group D showed significantly difference on prolongation of the survival time than group C (P<0.05).Conclusions: Overall, the curcumin-lipiodol emulsion injected into the portal vein and hepatic artery supplying the tumor can significantly inhibit angiogenesis and play a role in prolonging the OS time of model rabbits. The application of anti-adhesion film alone cannot inhibit tumor angiogenesis and play a role in prolonging the OS time of model rabbits. However, curcumin-lipiodol emulsion combined with antiadhesion film can obviously promote these effects.

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“…The other risk factors for intrahepatic biloma may include portal vein thrombosis, biliary obstruction and inflammation, the total number of TACE procedures undergone, and the total volume of iodized oil, anticancer drugs, microspheres, gelfoam and drug-eluting beads administered and undergoing segmental or subsegmental TACE (13,(18)(19)(20)(21). However, in the present study, with the exception of portal vein invasion in half of the patients, there was no obvious trend of repeat TACE procedures, embolic materials and anticancer drugs.…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic biloma following transcatheter arterial chemoembolization for hepatocellular carcinoma: Incidence, imaging features and management

Zhang

Guo

et al. 2017

Molecular and Clinical Oncology

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Abstract. Repeat transcatheter arterial chemoembolization (TACE) becomes more challenging for patients with intrahepatic biloma following TACE for hepatocellular carcinoma (HCC).The purpose of this study was to investigate the clinical course, incidence, imaging features and outcome and to explore the reasonable therapy scheme for intrahepatic biloma following TACE for HCC.A total of 4,695 TACE procedures were performed for 1,923 patients with HCC. Twenty patients with intrahepatic biloma following TACE were studied retrospectively. The incidence of intrahepatic biloma was 1.04% in this study. The 20 patients underwent 55 TACE procedures (mean, 2.75). Portal vein invasion was found in half of the patients. Eleven patients developed round solitary or multiple cystic biloma, 6 patients had branched biloma and 3 patients developed both cystic and branched biloma. Percutaneous drainage was applied for 4 patients. One patient underwent partial hepatectomy and one mortality occurred due to progressive biloma and multiple organ failure. Although severe intrahepatic biloma following TACE is rare, the procedure should be performed with caution. Timely and appropriate management, including percutaneous drainage, partial hepatectomy and antibiotic administration should be performed in the case of any signs of infection.

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Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Cited by 9 publications

References 30 publications

Biliary complications after transcatheter arterial chemoembolization for hepatocellular carcinoma

Biliary complications after transcatheter arterial chemoembolization for hepatocellular carcinoma

Effect of curcumin-lipiodol emulsion combined with absorbable anti-adhesion film through double embolic pathway on angiogenesis and overall survival (OS) time of VX2 liver cancer rabbits

Intrahepatic biloma following transcatheter arterial chemoembolization for hepatocellular carcinoma: Incidence, imaging features and management

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