Bacterial infections associated with hepatic arteriography and transarterial embolization for hepatocellular carcinoma: A prospective study

Sepsis and liver abscess are serious complications following transarterial embolization (TAE) for hepatocellular carcinoma (HCC). However, the exact i ncidence and the necessity of antibiotic prophylaxis remain undetermined. B etween November 1996 and November 1997, we prospectively studied bacterial infections in 231 HCC patients who underwent 287 angiographic procedures wi thout antibiotic prophylaxis, including 176 TAEs and 111 hepatic arteriogra phies (HAs), Four of the 111 HAs were complicated by transient asymptomatic bacteremia. Of the 176 TAEs, 2 were associated with asymptomatic bacteremi a, and 7 (4%) were associated with symptomatic bacterial infection, includi ng 3 cases of sepsis, 2 of liver abscess, and 2 of infected biloma, For pat ients with HCC, TAE was associated with a higher risk of developing symptom atic bacterial infections than was HA (4% vs. 0, respectively; P = .03). Pr evious gastrectomy was the only possible risk factor for liver abscess. Fin ally, early diagnosis and treatment of these infectious complications usual ly result in successful outcome.