title: Use of Prophylactic Antibiotics to Prevent Abscess Formation Following Hepatic Ablation in Patients with Prior Enterobiliary Manipulation.
abstract: Prior enterobiliary manipulation confers a high risk for liver abscess formation after hepatic ablation. We aimed to determine if prophylactic antibiotics could prevent post-ablation abscess in patients with a history of hepaticojejunostomy.
  
  
  
  This single-institution retrospective study identified 262 patients who underwent 307 percutaneous liver ablation sessions between January 2010 and August 2014. Twelve (4.6 %) patients with prior hepaticojejunostomy were included in this analysis. Ten (83> %) had received an aggressive prophylactic antibiotic regimen consisting of levofloxacin, metronidazole, neomycin, and erythromycin base. Two (16.6 %) had received other antibiotic regimens. Clinical, laboratory, and imaging findings were used to identify abscess formation and antibiotic-related side effects.
  
  
  
  Twelve ablation sessions were performed during the period studied. During a mean follow-up period of 440 days (range, 77-1784 days), post-ablation abscesses had developed in 2 (16.6 %) patients, who both received the alternative antibiotic regimens. None of the 10 patients who received the aggressive prophylactic antibiotic regimen developed liver abscess. One of the 10 patients who received the aggressive prophylactic antibiotic regimen developed grade 2 antibiotic-related diarrhea and arthralgia.
  
  
  
  An aggressive regimen of prophylactic antibiotics may be effective in preventing liver abscess formation after liver ablation in patients with prior hepaticojejunostomy.
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA. bcodisio@mdanderson.org.
authors.forename: Bruno C
authors.initials: BC
authors.lastname: Odisio
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Richter
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Aloia
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Claudius
authors.initials: C
authors.lastname: Conrad
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahrar
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vauthey
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, 1400 Pressler St. FCT14.5084, Houston, TX, 77030, USA.
authors.forename: Steven Y
authors.initials: SY
authors.lastname: Huang
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D018771:Arthralgia / Q000139:chemically induced; D003967:Diarrhea / Q000139:chemically induced; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007582:Jejunostomy; D008099:Liver / Q000601:surgery*; D008100:Liver Abscess / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Abscess; Antibiotics; Hepaticojejunostomy; Liver ablation