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Fei-shih Yang - One of the best experts on this subject based on the ideXlab platform.
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Biloma following repeated transcatheter arterial embolization and complicated by intrahepatic duct stones: a case report.
World journal of gastroenterology, 2005Co-Authors: Ming-jen Chen, Ching-chung Lin, Wen-hsiung Chang, Fei-shih YangAbstract:Biloma is an encapsulated bile collection outside the biliary tree due to a bile leak. It is occasionally found following traumatic liver injury or iatrogenic injury to the biliary tract, induced either during an endoscopic or surgical procedure. It is a rare complication of transcatheter arterial embolization (TAE). Although Biloma can be shrunk by appropriate aspiration or drainage in majority of cases, we report a case of intrahepatic Biloma following repeated TAE for hepatocellular carcinoma (HCC) and complicated by infection and intrahepatic stones. This particular constellation of problems has not been reported before and the intrahepatic stones need to be removed by percutaneous procedure.
Katsuhisa Omagari - One of the best experts on this subject based on the ideXlab platform.
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Intrahepatic Biloma Formation (Bile Duct Necrosis) After Transcatheter Arterial Chemoembolization
AJR. American journal of roentgenology, 2003Co-Authors: Ichiro Sakamoto, Soji Iwanaga, Kenji Nagaoki, Yojiro Matsuoka, Kazuto Ashizawa, Masataka Uetani, Toshio Fukuda, Tomoaki Okimoto, Sadayuki Okudaira, Katsuhisa OmagariAbstract:OBJECTIVE. The purpose of our study was to discuss the incidence, predisposing factors, and clinical course of intrahepatic Biloma after transcatheter arterial chemoembolization for hepatic tumors including hepatocellular carcinoma and metastatic liver tumor.MATERIALS AND METHODS. Nine hundred seventy-two patients with hepatocellular carcinoma (n = 920) or metastatic liver tumor (n = 52) underwent chemoembolization during a 12-year period beginning in January 1989. We retrospectively reviewed the medical records and follow-up radiographs of chemoembolization and analyzed the risk factors associated with the development of intrahepatic Biloma.RESULTS. Intrahepatic Biloma developed after chemoembolization in 35 patients (3.6%, 35/972) in our series. The incidence of intrahepatic Biloma formation in patients with metastatic liver tumor (9.6%, 5/52) was higher than that in patients with hepatocellular carcinoma (3.3%, 30/920) (p < 0.05, Fisher's exact test). The incidence of intrahepatic Biloma formation in p...
Yukio Osaki - One of the best experts on this subject based on the ideXlab platform.
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endoscopic ultrasonography guided transgastric drainage of infectious Biloma following radiofrequency ablation for hepatocellular carcinoma
Digestive Endoscopy, 2012Co-Authors: Yuji Eso, Hiroyuki Marusawa, Takehiko Tsumura, Yoshihiro Okabe, Yukio OsakiAbstract:An 87-year-old woman was diagnosed with a 22-mm diameter hepatocellular carcinoma in segment II and treated by percutaneous ultrasound-guided radiofrequency ablation (RFA). Six months later, she presented to the emergency room complaining of high fever and general malaise. Computed tomography (CT) images showed a 96 ¥ 60-mm fluid collection in the left lobe of the liver (Fig. 1). She was diagnosed with sepsis due to Biloma infection caused by RFAmediated bile duct disruption. Because the Biloma was adjacent to the stomach, we carried out endoscopic ultrasonography (EUS)-guided transgastric drainage of the Biloma. A discharge of pus was observed following the creation of internal and external fistulas between the Biloma and stomach using a 7-Fr double-pigtail stent and a 7.5-Fr singlepigtail tube (Fig. 2) and cultures of the purulent fluid grew Escherichia coli. A CT scan obtained 4 weeks after drainage confirmed complete resolution of the Biloma and the patient recovered uneventfully. Although Biloma formation related to bile duct disruption is a frequent complication of RFA, Biloma infection complicated with bacteremia is very rare. Bilomas are usually treated by either percutaneous drainage or surgery. This patient, however, was very elderly and had advanced dementia, so it was difficult for her to keep still during percutaneous puncture. In addition, the risk for self-removal of the drainage tube was considered to be high. The utility of EUSguided drainage of intra-abdominal fluid collections is well documented, whereas there have been a small number of reports on EUS-guided drainage of Bilomas. The Biloma in this patient was located adjacent to the stomach; therefore, EUS-guided drainage was considered to be a promising alternative and was successfully carried out. In summary, the risk of Biloma infection should be considered, especially in putative immune-compromised older patients. Moreover, careful attention must be paid to the possibility of delayed Biloma infection even 6 months after RFA.
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Endoscopic ultrasonography‐guided transgastric drainage of infectious Biloma following radiofrequency ablation for hepatocellular carcinoma
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2012Co-Authors: Yuji Eso, Hiroyuki Marusawa, Takehiko Tsumura, Yoshihiro Okabe, Yukio OsakiAbstract:An 87-year-old woman was diagnosed with a 22-mm diameter hepatocellular carcinoma in segment II and treated by percutaneous ultrasound-guided radiofrequency ablation (RFA). Six months later, she presented to the emergency room complaining of high fever and general malaise. Computed tomography (CT) images showed a 96 ¥ 60-mm fluid collection in the left lobe of the liver (Fig. 1). She was diagnosed with sepsis due to Biloma infection caused by RFAmediated bile duct disruption. Because the Biloma was adjacent to the stomach, we carried out endoscopic ultrasonography (EUS)-guided transgastric drainage of the Biloma. A discharge of pus was observed following the creation of internal and external fistulas between the Biloma and stomach using a 7-Fr double-pigtail stent and a 7.5-Fr singlepigtail tube (Fig. 2) and cultures of the purulent fluid grew Escherichia coli. A CT scan obtained 4 weeks after drainage confirmed complete resolution of the Biloma and the patient recovered uneventfully. Although Biloma formation related to bile duct disruption is a frequent complication of RFA, Biloma infection complicated with bacteremia is very rare. Bilomas are usually treated by either percutaneous drainage or surgery. This patient, however, was very elderly and had advanced dementia, so it was difficult for her to keep still during percutaneous puncture. In addition, the risk for self-removal of the drainage tube was considered to be high. The utility of EUSguided drainage of intra-abdominal fluid collections is well documented, whereas there have been a small number of reports on EUS-guided drainage of Bilomas. The Biloma in this patient was located adjacent to the stomach; therefore, EUS-guided drainage was considered to be a promising alternative and was successfully carried out. In summary, the risk of Biloma infection should be considered, especially in putative immune-compromised older patients. Moreover, careful attention must be paid to the possibility of delayed Biloma infection even 6 months after RFA.
Ming-jen Chen - One of the best experts on this subject based on the ideXlab platform.
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Biloma following repeated transcatheter arterial embolization and complicated by intrahepatic duct stones: a case report.
World journal of gastroenterology, 2005Co-Authors: Ming-jen Chen, Ching-chung Lin, Wen-hsiung Chang, Fei-shih YangAbstract:Biloma is an encapsulated bile collection outside the biliary tree due to a bile leak. It is occasionally found following traumatic liver injury or iatrogenic injury to the biliary tract, induced either during an endoscopic or surgical procedure. It is a rare complication of transcatheter arterial embolization (TAE). Although Biloma can be shrunk by appropriate aspiration or drainage in majority of cases, we report a case of intrahepatic Biloma following repeated TAE for hepatocellular carcinoma (HCC) and complicated by infection and intrahepatic stones. This particular constellation of problems has not been reported before and the intrahepatic stones need to be removed by percutaneous procedure.
Ichiro Sakamoto - One of the best experts on this subject based on the ideXlab platform.
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Intrahepatic Biloma Formation (Bile Duct Necrosis) After Transcatheter Arterial Chemoembolization
AJR. American journal of roentgenology, 2003Co-Authors: Ichiro Sakamoto, Soji Iwanaga, Kenji Nagaoki, Yojiro Matsuoka, Kazuto Ashizawa, Masataka Uetani, Toshio Fukuda, Tomoaki Okimoto, Sadayuki Okudaira, Katsuhisa OmagariAbstract:OBJECTIVE. The purpose of our study was to discuss the incidence, predisposing factors, and clinical course of intrahepatic Biloma after transcatheter arterial chemoembolization for hepatic tumors including hepatocellular carcinoma and metastatic liver tumor.MATERIALS AND METHODS. Nine hundred seventy-two patients with hepatocellular carcinoma (n = 920) or metastatic liver tumor (n = 52) underwent chemoembolization during a 12-year period beginning in January 1989. We retrospectively reviewed the medical records and follow-up radiographs of chemoembolization and analyzed the risk factors associated with the development of intrahepatic Biloma.RESULTS. Intrahepatic Biloma developed after chemoembolization in 35 patients (3.6%, 35/972) in our series. The incidence of intrahepatic Biloma formation in patients with metastatic liver tumor (9.6%, 5/52) was higher than that in patients with hepatocellular carcinoma (3.3%, 30/920) (p < 0.05, Fisher's exact test). The incidence of intrahepatic Biloma formation in p...