Kim Jong Yeong, Oh Jung Suk, Chun Ho Jong, Kim Su Ho
J Korean Soc Radiol. 2024 Mar;85(2):363-371. doi: 10.3348/jksr.2023.0084. Epub 2023 Dec 9.
Acute cholecystitis is a complication of transarterial chemoembolization (TACE) that occasionally requires surgical intervention. We aimed to analyze the incidence and risk factors of cholecystitis requiring surgical intervention in patients with embolic material uptake on cone beam CT (CBCT) performed immediately after various TACE procedures.
After a retrospective review of 2633 TACE procedures performed over a 6-year period, 120 patients with embolic material retention in the gallbladder wall on CBCT immediately after TACE were selected. We analyzed the incidence of and risk factors for acute cholecystitis.
The overall incidence of acute cholecystitis requiring surgical intervention was 0.45% (12 of 2633 TACE procedures); however, it was present in 10% (12 of 120) of procedures that showed high-density embolic material retention in the gallbladder wall on CBCT performed immediately after TACE. Acute cholecystitis requiring surgical intervention occurred in eight patients (66.7%) who underwent direct cystic arterial embolization. Surgical intervention was performed 15 days (mean) after TACE.
Most unintended chemolipiodol deposits in the gallbladder wall resolved without intervention or surgery. However, superselective direct cystic arterial chemoembolization was associated with a high incidence of acute cholecystitis requiring surgery, and patients who undergo this procedure should be closely monitored.
急性胆囊炎是经动脉化疗栓塞术（TACE）的一种并发症，偶尔需要手术干预。我们旨在分析在各种TACE术后立即进行的锥形束CT（CBCT）检查显示有栓塞物质摄取的患者中，需要手术干预的胆囊炎的发生率及危险因素。
在对6年期间进行的2633例TACE手术进行回顾性分析后，选择了120例TACE术后立即在CBCT上显示胆囊壁有栓塞物质残留的患者。我们分析了急性胆囊炎的发生率及危险因素。
需要手术干预的急性胆囊炎的总体发生率为0.45%（2633例TACE手术中有12例）；然而，在TACE术后立即进行的CBCT显示胆囊壁有高密度栓塞物质残留的手术中，其发生率为10%（120例中有12例）。需要手术干预的急性胆囊炎发生在8例（66.7%）接受直接胆囊动脉栓塞的患者中。手术干预在TACE术后15天（平均）进行。
大多数胆囊壁意外的碘油沉积无需干预或手术即可消退。然而，超选择性直接胆囊动脉化疗栓塞术与需要手术的急性胆囊炎的高发生率相关，接受该手术的患者应密切监测。
