Yoshiaki Egashira, Presenter: Nothing to Disclose

Junichi Nojiri, Abstract Co-Author: Nothing to Disclose

Hiroyuki Irie MD, Abstract Co-Author: Nothing to Disclose

Noriyuki Kamochi, Abstract Co-Author: Nothing to Disclose

Masanobu Mizuguchi MD, Abstract Co-Author: Nothing to Disclose

Sho Kudo MD, PhD, Abstract Co-Author: Nothing to Disclose

To compare the incidence of biliary complication after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) using conventional and novel embolic materials, that is, gelatin sponge particles (GSP) and porous gelatin particles (PGP). To clarify the risk factors for biliary complication after TACE for HCC using two different embolic materials.

112 consecutive patients (189 procedures) with HCC who were treated by TACE using GSP (group 1: 62 patients) or PGP (group 2: 73 patients) without additional treatment constituted the study population. The biliary complication was defined as biloma formation or newly developed intrahepatic bile duct dilatation on enhanced CT or MRI obtained more than two months after TACE. Analysis was performed treated segments basis (304 segments). Incidence of biliary complication was calculated. Analyzed possible risk factors for biliary complication were embolic materials, preceded simple embolization, treatment frequency, pre-existent biliary dilatation, degree of embolization, and dense artery sign (DAS: defined as densely seen hepatic arterial branches on fluoroscopy after treatment due to stagnation of Lipiodol or contrast material). Multivariable analysis was performed using Logistic regression analysis.

Although there was statistical difference in age distributions (older in group 2), there was no other significant difference in patient characteristic between the two groups. The incidence of biliary complication was significantly higher (P<0.01) on group 1 (10 segments) than group 2 (31 segments). Multivariable analysis disclosed that PGP (odds ratio: 4.15, 95% CI [confidence interval]: 1.69-10.19), positive DAS (odds ratio: 6.19, 95% CI: 2.68-14.32) and pre-existent biliary dilatation (odds ratio: 2.92, 95% CI: 1.11-7.65) were significant predictors for biliary complication after TACE. Furthermore, positive DAS in the group 2 had a greater risk than that in the group 1 (odds ratio: 13.08, 95% CI: 4.6-37.21). For pre-existent biliary dilatation, there was no significant risk difference between the two groups (odds ratio: 0.85, 95% CI: 0.19-3.92).

Biliary complication may be frequently encountered on TACE for HCCs using porous gelatin particles.

Knowledge of incidence and risk factors for biliary complication after TACE for HCC is mandatory for appropriate treatment and benefits thepatients.

Egashira, Y, Nojiri, J, Irie, H, Kamochi, N, Mizuguchi, M, Kudo, S, Biliary Complication after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Incidence and Risk Factors between Using Gelatin Sponge Particles and Porous Gelatin Particles.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009989.html