Hepatic and biliary damage after transarterial chemoembolization for malignant hepatic tumors: incidence, diagnosis, treatment, outcome and mechanism

Crit Rev Oncol Hematol. 2011 Aug;79(2):164-74. doi: 10.1016/j.critrevonc.2010.07.019. Epub 2010 Aug 16.

Abstract

Objective: To provide an overview of recent studies on transarterial chemoembolization-related hepatic and biliary damage (TRHBD) in patients with malignant hepatic tumors (MHT) and to explore the reasons for TRHBD.

Methods: Literature on the treatments for MHT by TACE was sought in PubMed and the related information was summarized.

Results: TRHBD is found to occur in the hepatic parenchymal cells, biliary tree and blood-vascular system. The damage is mainly due to ischemia resulting from embolic materials such as gelatin sponge and lipiodol. In addition, clinicians' skill levels in non-superselective catheterization, the health condition of the patients, and the chemical agents used may also be related to the damage. Most of the deterioration can be reversed if the patients are diagnosed and treated properly and promptly.

Conclusions: Understanding the mechanisms of TRHBD more comprehensively is helpful in developing effective methods for prevention and treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Biliary Tract / blood supply
  • Biliary Tract / pathology
  • Carcinoma, Hepatocellular / blood supply
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / adverse effects*
  • Chemoembolization, Therapeutic / methods
  • Cholecystitis / diagnosis
  • Cholecystitis / epidemiology
  • Cholecystitis / therapy*
  • Databases, Bibliographic
  • Drainage / methods
  • Ethiodized Oil / adverse effects
  • Gelatin Sponge, Absorbable / adverse effects
  • Humans
  • Incidence
  • Liver / blood supply
  • Liver / pathology
  • Liver Abscess / diagnosis
  • Liver Abscess / epidemiology
  • Liver Abscess / therapy*
  • Liver Function Tests
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Male
  • Necrosis / diagnosis
  • Necrosis / epidemiology
  • Necrosis / therapy*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / therapy*
  • Sex Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Ethiodized Oil