title: Biliary complications of arterial chemoembolization of hepatocellular carcinoma.
abstract: BACKGROUND
  Transarterial chemoembolization (TACE) is the most frequently used palliative therapy for unresectable hepatocellular carcinoma (HCC). It is a safe and effective procedure with few major and minor complications. Rarely, biliary complications are also encountered following TACE. The goal of our study was to investigate the incidence and the presentation of biliary complications following TACE in patients with HCC.
  
  
  METHODS
  In this retrospective study, data of patients with HCC who underwent TACE between June 2002 to December 2014 were obtained from the records. Their detailed information about the procedure of TACE, diagnosis of biliary complications and subsequent management details were reviewed.
  
  
  RESULTS
  One hundred and sixty-eight patients with HCC underwent 305 procedures of TACE. Of these, biliary complications of various severities developed in 6 (3.6%) patients leading to an incidence of 1.9% (6/305). Minimal intrahepatic biliary dilatation (IHBD) occurred in three, biliary stricture in one and intrahepatic biloma in two patients. Supportive management was undertaken for IHBD patients while percutaneous aspiration and naso-biliary drainage was performed for the infected bilomas.
  
  
  CONCLUSIONS
  Biliary complications following TACE are infrequent. Diagnosis should be suspected clinically and confirmed with imaging. Treatment depends on the severity. Enforcing specific measures can minimize its frequency.
authors: Departments of Radio Diagnosis and Gastroenterology, All India Institute of Medical Sciences, 110 029 New Delhi, India.
authors: E
authors: E
authors: Dhamija
authors: Departments of Radio Diagnosis and Gastroenterology, All India Institute of Medical Sciences, 110 029 New Delhi, India. Electronic address: shashi.aiims@gmail.com.
authors: S B
authors: SB
authors: Paul
authors: Departments of Radio Diagnosis and Gastroenterology, All India Institute of Medical Sciences, 110 029 New Delhi, India.
authors: S R
authors: SR
authors: Gamanagatti
authors: Departments of Radio Diagnosis and Gastroenterology, All India Institute of Medical Sciences, 110 029 New Delhi, India.
authors: S K
authors: SK
authors: Acharya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries; D001649:Bile Duct Diseases / Q000209:etiology*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Biliary complications; Biloma; Hepatocellular carcinoma (HCC); Transarterial chemoembolization (TACE)