Severe biliary complications after hepatic artery embolization.
OBJECTIVE
To study the mechanism and treatment of severe biliary complications arising from hepatic artery embolization(HAE).


METHODS
Of seven cases of intra- and extrahepatic biliary damage resulting from hepatic artery embolization reported since 1987, 6 patients suffered from hepatic haemangioma, the other case was due to injection of TH compound into the hepatic artery during operation. The hepatic artery was injected with ethanol so as to evaluate the liver damage in experimental rats.


RESULTS
All the cases were found to have destructive damage of intra- and extrahepatic bile duct at the hilum with biliary hepatocirrhosis. Experimental results revealed necrosis of the liver parenchyma, especially around the portal tract and obliteration of intrahepatic bile duct.


CONCLUSIONS
To prevent the severe biliary complications of HAE, the use of HAE for hepatic haemangioma which was widely practiced in China, should be re-evaluated. Hepatic arterial embolization of hepatic haemangioma may resulte in severe destructive biliary damages and its indiscriminate use should be prohibited.
Huang
Xiao-Qiang
XQ
Department of Hepatobiliary Surgery, General Hospital of PLA, 28 Fuxing Road, Beijing 100853,China. huangxq@ht.rol.cn.net
Huang
Zhi-Qiang
ZQ
Duan
Wei-Dong
WD
Zhou
Nin-Xing
NX
Feng
Yu-Quan
YQ
D000328:Adult; D000818:Animals; D001649:Bile Duct Diseases / Q000209:etiology* / Q000473:pathology; D017734:Bile Ducts, Extrahepatic / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D002779:Cholestasis / Q000209:etiology* / Q000473:pathology; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006391:Hemangioma / Q000473:pathology / Q000628:therapy*; D006499:Hepatic Artery; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D051381:Rats; D017208:Rats, Wistar