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Gallbladder infarction after hepatic artery embolization.

K Takayasu, N Moriyama, Y Muramatsu

    AJR. American Journal of Roentgenology
    |January 1, 1985
    PubMed
    Summary
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    Transcatheter hepatic arterial embolization for liver cancer can inadvertently affect the cystic artery, leading to gallbladder inflammation. While this complication caused pain in most patients, it did not require surgical intervention.

    Area of Science:

    • Hepatobiliary Surgery
    • Interventional Radiology
    • Oncology

    Background:

    • Hepatocellular carcinoma (HCC) management often involves transcatheter hepatic arterial embolization (TACE).
    • TACE is frequently followed by surgical resection for HCC.
    • Cholecystectomy is sometimes performed concurrently with hepatic resection.

    Observation:

    • Inadvertent embolization of the cystic artery occurred in 53% of patients during TACE for HCC.
    • The cystic artery supplies blood to the gallbladder.
    • This complication was noted during the angiographic procedure.

    Findings:

    • Histologic examination revealed necrotizing ulcerative cholecystitis in 90% of patients with cystic artery embolization.
    • Nine out of ten patients experienced right-upper-quadrant pain post-embolization.

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  • The severity of pain varied among affected patients.

    • Implications:

    • Cystic artery embolization is a potential complication of TACE for HCC.
    • Necrotizing ulcerative cholecystitis and associated pain can occur after inadvertent cystic artery embolization.
    • Conservative management appears sufficient for this complication, avoiding urgent laparotomy.