HCC : PE-053 ; Predicting risk factors and clinical features of liver abscess in HCC patients with postembolization syndrome after TACE = HCC : PE-053 ; Predicting risk factors and clinical features of liver abscess in HCC patients with postembolization syndrome after TACE

다국어 초록 (Multilingual Abstract)

Background: Liver abscess was very rare but serious complication lead to liver failure and fatal outcomes after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). This study was evaluated to clinical features of TACE related liver abscess and predicting risk factors among HCC patients who developed postembolization syndrome after TACE. Methods: From January 2008 to December 2010, 13 patients of liver abscess which was undergone percutanous drainage developed in 2582 sessions of TACE. There was retrospectively analyzed to clinical features and predicting risk factors of liver abscess compared with control group who was selected 181 patients with fever after TACE. Results: The incidence of liver abscess was 0.5%. The etiologic types were necrosis related abscess (7 cases, 54%), biloma related abscess (4 cases, 31%), indirect abscess (2 cases, 15%). The mean interval time between percutanous drainage and TACE was 51±38 days. The positive culture rate was 69 % (9 cases) and organisms were enterococcus (4), Klebsiella pnemumoniae (2), Escherichia coli (1), Citrobacter (1) and Clostridium difficile (1). Abscess group was more higher peak AST level, peak bilirubin level, single nodular type HCC, Choledocholithiasis, air forming tumoral necrosis than control group. Independent predicting risk factors to abscess was only large air forming tumoral necrosis. The overall mortality rate of abscess was 61%. 6 patients were died caused by directly related to abscess. Conclusions: TACE related liver abscess was fatal infectious complication related to extensive air forming tumoral necrosis. The clinician should be considered to possibility of developing abscess in HCC patient with high risk factors after TACE.