Acute Ischemic Cholecystitis After Transarterial Chemoembolization of Hepatocellular Carcinoma
- 1 May 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Computer Assisted Tomography
- Vol. 34 (3), 348-353
- https://doi.org/10.1097/rct.0b013e3181caaea3
Abstract
To determine the incidence and clinical outcome of acute ischemic cholecystitis after transarterial chemoembolization (TACE) of hepatocellular carcinoma. In this ethics board-approved study, a retrospective review of 355 TACE procedures performed in 246 patients during a 5-year period was performed. The review of postintervention computed tomography (CT) reports for findings indicative of acute cholecystitis identified 12 patients (4.9%). In these patients, all CT scans, laboratory results (white blood cell count, alkaline phosphatase level, total bilirubin level), and clinical reports were analyzed to assess imaging findings and outcomes at the following time points: before TACE, within the first week after the procedure, as well as 1 and 6 months post-TACE. In 11 of 12 cases, the dominant finding on CT was new gallbladder wall thickening of up to 12 mm, which developed within 24 hours in 10 patients and within the first month after TACE in 1 patient. Gallbladder wall thickening persisted in 1 patient for at least 6 months. Eleven of 12 patients showed deposition of Lipiodol in the gallbladder wall. In 1 patient, the dominant finding on CT was pericholecystic stranding that resolved on follow-up CT after 1 month. None of the patients demonstrated gas in the gallbladder wall, significant pericholecystic fluid, abdominal or liver abscesses. Blood work results revealed transient increase in white blood cell count, alkaline phosphatase level, and total bilirubin level, not different from that seen after TACE in patients without CT evidence of cholecystitis. Clinical reports documented transient right upper quadrant pain for a few days and up to 1 month in 1 case with eventual symptom relief. None of the cases required surgical or radiological intervention. All but 1 case demonstrated normal gallbladder wall thickness after 6 months. Acute ischemic cholecystitis is not an uncommon complication after TACE. However, it is self-limiting and does not seem to require any intervention or surgery.Keywords
This publication has 24 references indexed in Scilit:
- Chemoembolization in the Management of Liver TumorsThe Oncologist, 2003
- Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trialThe Lancet, 2002
- Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinomaHepatology, 2002
- Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization.Radiology, 1993
- Diagnostic iodised oil embolisation of liver tumours — the Hammersmith experienceEuropean Journal of Radiology, 1993
- Gallbladder infarction after hepatic artery embolizationAmerican Journal of Roentgenology, 1985
- Apudomas metastatic to the liver: treatment by hepatic artery embolization.Radiology, 1983
- Gallbladder infarction following hepatic transcatheter arterial embolization. Angiographic study.Radiology, 1983
- Hepatic artery embolization in 120 patients with unresectable hepatoma.Radiology, 1983
- Hepatic artery embolization in the treatment of hepatic neoplasms.Radiology, 1981