title: Evaluation of infectious complications following percutaneous liver ablation in patients with bilioenteric anastomoses.
abstract: Prior bilioenteric anastomosis (BEA) has been associated with elevated risk of abscess formation after thermal ablation of hepatic tumors. We assessed the incidence of hepatic abscess after thermal ablation in a BEA cohort treated with extended antibiotic regimens following ablation.
  
  
  
  Retrospective review was performed to identify patients with BEA who underwent percutaneous hepatic thermal ablation between January 1, 2003-September 1, 2016. Fifteen patients with BEA underwent 18 percutaneous thermal ablation procedures. Patient and procedural characteristics were reviewed, as well as the antibiotic regiment utilized post ablation. Complications were characterized via standardized nomenclature [Common Terminology for Clinically Adverse Events (CTCAE) v4.03].
  
  
  
  Fifteen patients with BEA underwent treatment of 49 liver lesions during 18 ablation sessions. Mean follow-up in these patients was 39 months (range 3-138 months). Two patients (11%) developed hepatic abscesses, both of which occurred within 45 days of the ablation procedure while the patients were still on extended prophylactic antibiotic therapy. No additional CTCAE clinically significant complications were observed.
  
  
  
  Thermal ablation of hepatic tumors can be accomplished safely in patients with BEA. Long-term post-procedural antibiotics may mitigate the risk of hepatic abscess formation. Due to the high number of patients who are deemed surgically unresectable, patients with BEA may have limited alternate treatment modalities and percutaneous hepatic thermal ablative treatments warrant consideration.
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA. Welch.brian@mayo.edu.
authors.forename: B T
authors.initials: BT
authors.lastname: Welch
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Schmitz
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Atwell
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: McGauvran
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA.
authors.forename: A N
authors.initials: AN
authors.lastname: Kurup
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Callstrom
authors.affiliation: Mayo Clinic Department of Radiology, 200 1st ST SW, Rochester, MN, 55905, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Schmit
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis; D017115:Catheter Ablation / Q000009:adverse effects*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000517:prevention & control; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Hepatic neoplasms; Percutaneous ablation; Tumor ablation