Liver abscess after percutaneous radiofrequency ablation for hepatocellular carcinomas: frequency and risk factors.
OBJECTIVE
The purpose of this study was to clarify the frequency and risk factors of liver abscess formation after percutaneous radiofrequency ablation in patients with hepatocellular carcinoma.


METHODS
Over a 4-year period, 603 patients with 831 hepatocellular carcinomas measuring 5 cm or less in maximum diameter who underwent a total of 751 percutaneous radiofrequency ablation procedures were enrolled in this study. We retrospectively reviewed the medical records and analyzed the overall frequency of liver abscess, risk factors for abscess, and clinical features of the patients. The relationships between liver abscess and potential risk factors were analyzed using either generalized estimating equations or multiple logistic regression analysis.


RESULTS
Liver abscess developed in 14 tumors of 13 patients after 13 (13/751 [1.7%]) ablation procedures. Generalized estimating equations and multiple logistic regression analysis of various potential risk factors revealed that preexisting biliary abnormality prone to ascending biliary infection (p = 0.0088), tumor with retention of iodized oil from previous transcatheter arterial chemoembolization (p = 0.040), and treatment with an internally cooled electrode system (p = 0.016) were associated with a significant risk of liver abscess formation. No patient died of liver abscess, and all successfully recovered from liver abscess with parenteral antibiotics and percutaneous clearance of pus.


CONCLUSIONS
Although liver abscess formation was infrequent in patients who underwent percutaneous radiofrequency ablation for hepatocellular carcinoma, the patients with significant risk factors-preexisting biliary abnormality prone to ascending biliary infection, tumor with retention of iodized oil, and treatment with an internally cooled electrode system-for liver abscess formation should be closely monitored after treatment.
Choi
Dongil
D
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-ku, Seoul 135-710, South Korea.
Lim
Hyo K
HK
Kim
Min Ju
MJ
Kim
Suk Jung
SJ
Kim
Seung Hoon
SH
Lee
Won Jae
WJ
Lim
Jae Hoon
JH
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
Choi
Moon Seok
MS
Kim
Seonwoo
S
D000772:Anesthesia, Local; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D016292:Procedural Sedation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008100:Liver Abscess / Q000175:diagnosis / Q000453:epidemiology*; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed