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[Liver abscesses--complications after prosthesis and stent occlusions]
1Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH.
Ultraschall in Der Medizin (Stuttgart, Germany : 1980)
|March 10, 1998
Summary
Biliary strictures treated with stents can lead to liver abscesses, particularly with plastic stents and after percutaneous transhepatic drainage. Early diagnosis and drainage are key to successful treatment.
Area of Science:
- Hepatology
- Gastroenterology
- Interventional Radiology
Background:
- Malignant biliary strictures often require endoprosthesis or stent placement for drainage.
- Patients with these devices are at risk of developing liver abscesses.
Purpose of the Study:
- To investigate the relationship between biliary strictures, endoprostheses/stents, and liver abscess formation.
- To identify factors contributing to the development of liver abscesses in this patient population.
Main Methods:
- Retrospective study of 9 patients with liver abscess and endoprosthesis/stents.
- Sonography and either endoscopic retrograde cholangiopancreatography (ERC) or percutaneous transhepatic cholangiography (PTC) for diagnosis.
- Percutaneous drainage (PTCD) and antibiotic therapy for abscess treatment.
Main Results:
- 56% of patients had intrahepatic bile duct carcinoma; other causes included distal tumors, gallbladder tumors, and liver metastases.
- Plastic endoprostheses occluded faster (5 months) than stents (17.6 months).
- 78% of abscesses were cured with drainage and antibiotics; two cases required percutaneous drainage.
Conclusions:
- Liver abscesses are frequently associated with intrahepatic carcinomas.
- Drainage in these cases is challenging and often requires multiple interventions.
- Percutaneous transhepatic drainage and plastic endoprostheses are associated with higher risks.