Liver abscess after percutaneous radiofrequency ablation for hepatocellular carcinomas: Frequency and risk factors

Dongil Choi, Hyo K. Lim, Min Ju Kim, Suk Jung Kim, Seung Hoon Kim, Won Jae Lee, Jae Hoon Lim, Seung Woon Paik, Byung Chul Yoo, Moon Seok Choi, Seonwoo Kim

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Abstract

OBJECTIVE. The purpose of this study was to clarify the frequency and risk factors of liver abscess formation after percutaneous radiofrequency ablation in patients with hepatocellular carcinoma. MATERIALS AND METHODS. Over a 4-year period, 603 patients with 831 hepatocellular carcinomas measuring 5 cm or less in maximum diameter who underwent a total of 751 percutaneous radiofrequency ablation procedures were enrolled in this study. We retrospectively reviewed the medical records and analyzed the overall frequency of liver abscess, risk factors for abscess, and clinical features of the patients. The relationships between liver abscess and potential risk factors were analyzed using either generalized estimating equations or multiple logistic regression analysis. RESULTS. Liver abscess developed in 14 tumors of 13 patients after 13 (13/751 [1.7%]) ablation procedures. Generalized estimating equations and multiple logistic regression analysis of various potential risk factors revealed that preexisting biliary abnormality prone to ascending biliary infection (p = 0.0088), tumor with retention of iodized oil from previous transcatheter arterial chemoembolization (p = 0.040), and treatment with an internally cooled electrode system (p = 0.016) were associated with a significant risk of liver abscess formation. No patient died of liver abscess, and all successfully recovered from liver abscess with parenteral antibiotics and percutaneous clearance of pus. CONCLUSION. Although liver abscess formation was infrequent in patients who underwent percutaneous radiofrequency ablation for hepatocellular carcinoma, the patients with significant risk factors-preexisting biliary abnormality prone to ascending biliary infection, tumor with retention of iodized oil, and treatment with an internally cooled electrode system-for liver abscess formation should be closely monitored after treatment.

Original languageEnglish
Pages (from-to)1860-1867
Number of pages8
JournalAmerican Journal of Roentgenology
Volume184
Issue number6
DOIs
Publication statusPublished - 2005 Jan 1
Externally publishedYes

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Choi, D., Lim, H. K., Kim, M. J., Kim, S. J., Kim, S. H., Lee, W. J., Lim, J. H., Paik, S. W., Yoo, B. C., Choi, M. S., & Kim, S. (2005). Liver abscess after percutaneous radiofrequency ablation for hepatocellular carcinomas: Frequency and risk factors. American Journal of Roentgenology, 184(6), 1860-1867. https://doi.org/10.2214/ajr.184.6.01841860