REAPPRAISAL OF GASTRODUODENAL LESIONS AFTER TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION OF LIVER NEOPLASMS - SELECTIVE VERSUS SUPERSELECTIVE METHOD

Twenty-six patients with liver neoplasm receiving transcatheter arteri al chemoembolization (TAE) therapy underwent gastroduodenal endoscopic examinations before and after TAE. The balloon was inflated in the co mmon hepatic artery before chemoembolization if superselective cannula tion beyond the gastroduodenal artery could not be done. Sixteen of th e 26 patients (61.5%) showed new gastroduodenal lesions, with superfic ial gastritis in six, one or more erosions in nine, and hemorrhagic ga stritis in five. The frequency of lesions detected was no different wh en the common hepatic artery was obstructed (60.0%) than when supersel ective embolization was done in more peripheral branch(es) (60.0%). No clinical events indicating upper gastrointestinal bleeding were notic ed after TAE. The presence of esophageal and/or gastric varices and se ssion(s) of TAE performed before did not affect the occurrence of gast roduodenal lesion(s). We conclude that TAE produces erosive gastroduod enal lesions that are detected by endoscopic examination but are clini cally unimportant; balloon catheter occlusion of the common hepatic ar tery did not result in more frequent gastroduodenal complications than the ordinary superselective chemoembolization method.