[Analysis of severe complications after transcatheter arterial chemoembolization for primary hepatocellular carcinoma].
OBJECTIVE
To investigate the cause and treatment as well as prevention measures of rarely occurring severe complications after transcatheter arterial chemoembolization (TACE) for primary hepatic carcinoma.


METHODS
573 consecutive patients with primary hepatic carcinoma underwent a total of 1252 TACE procedures from January 2005 to July 2007. All the patients who developed complications after TACE received imaging and biochemical examinations. The cause, treatment and preventive measures of the complications in the 573 cases were analyzed.


RESULTS
There were upper gastrointestinal hemorrhage in 3 cases, hepatic failure in 4, pulmonary embolism in 1, cholecystitis in 4, hepatic encephalopathy in 2, gastric perforation in 1, and intrahepatic biloma in 2 cases. Two patients died of the complications: 1 of hepatic failure and 1 of gastric perforation.


CONCLUSIONS
The rarely occurring severe complications after transcatheter arterial chemoembolization for primary hepatic carcinoma is correlated with poor hepatic function and portal hypertension before therapy, overdose and reflux of chemotherapeutic agents or allotopic chemoembolism, etc. It can be reduced or prevented through careful selection of proper cases before the treatment, close observation, and protection of hepatic function and gastric mucosa after treatment.
Liang
Song-Nian
SN
Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Liu
Lin-Lin
LL
Su
Hong-Ying
HY
Feng
Bo
B
Zhao
Guang-Sheng
GS
Xu
Ke
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage / Q000009:adverse effects; D017093:Liver Failure / Q000209:etiology*; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects; D011655:Pulmonary Embolism / Q000209:etiology; D055815:Young Adult
D015251:Epirubicin; D016685:Mitomycin; D007459:Iodized Oil; D005472:Fluorouracil