Rudnick Peter, Feia Kaleb, Laeseke Paul, Herman Joseph, Geschwind Jeff
School of Medicine, Creighton University, Omaha, NE 68178, USA.
Department of Biochemistry and Molecular Biology, University of Iowa, Iowa City, IA 52242, USA.
Diagnostics (Basel). 2025 Jan 30;15(3):333. doi: 10.3390/diagnostics15030333.
Intrahepatic abscess is an exceedingly rare complication of locoregional therapy for patients with liver cancer. However, in patients who underwent prior hepatobiliary intervention, the incidence of liver abscess increases significantly, causing morbidity and even mortality in such patients. Here, we will review the relative risk of developing a liver abscess after intraarterial and ablative locoregional therapies in patients with liver cancer depending on whether they underwent any kind of prior hepatobiliary procedures that resulted in violation of the Ampulla of Vater. As a result, patients deemed at high risk of developing a liver abscess were treated prophylactically, with the combination of bowel preparation and antibiotics nearly eliminating the occurrence of a liver abscess after locoregional therapy. Therefore, given the significant risk of developing a liver abscess in patients with prior hepatobiliary procedures, management consisting of prophylactic bowel preparation with antibiotic coverage followed by antibiotics post-locoregional therapy is recommended.
肝内脓肿是肝癌局部区域治疗极为罕见的并发症。然而，在接受过先前肝胆介入治疗的患者中，肝脓肿的发生率显著增加，可导致此类患者发病甚至死亡。在此，我们将根据肝癌患者是否接受过任何导致 Vater 壶腹受损的先前肝胆手术，来回顾动脉内和消融局部区域治疗后发生肝脓肿的相对风险。结果显示，被认为发生肝脓肿高风险的患者接受了预防性治疗，肠道准备和抗生素联合使用几乎消除了局部区域治疗后肝脓肿的发生。因此，鉴于先前接受过肝胆手术的患者发生肝脓肿的风险显著，建议采用预防性肠道准备并覆盖抗生素，随后在局部区域治疗后使用抗生素的管理方法。
