INFECTIOUS COMPLICATIONS OF HEPATIC CRYOSURGERY

Hepatic cryosurgery is a novel procedure for patients with metastatic liver disease. To date, no reviews of the infectious complications of this procedure have been published. One hundred and fifty patients und erwent 158 hepatic cryosurgical procedures at Allegheny General Hospit al (Pittsburgh) from November 1987 through July 1995, Gastrointestinal malignancies accounted for 93% of the underlying diagnoses. The follo wing 12 infections were directly related to the cryosurgical procedure : hepatic abscess (six), intraperitoneal abscess (three), ascending ch olangitis (two), and an intrahepatic device (Infusaid; Strato/Infusoid , Norwood, MA) infection (one). Enterococcus was the most commonly iso lated organism, Seven of the 12 infections were polymicrobial. The pat ients who developed infections had longer hospital stays (26 days vs, 13 days) and had more days of fever (6.5 days vs, 2.3 days). than thos e who did not develop infections. If perioperative manipulation of the biliary tree is avoided, the infection rate in patients who undergo h epatic cryosurgery may be decreased even further. Overall, cryoablatio n of the liver is not related to an increased risk of infection.