Abstract
PURPOSE: In order to review various complications and their frequencies and causes after
chemoembolization in the patients with hepatic neoplasm.
Subjects and Methods:Subjects were 362 patients who underwent chemoembolization for hepatic
neoplasm during the recent 2 years from Jan. 1990 to Dec. 1992. A total of 954 procedures were performed in these
patients. For the initial treatment, only the emulsion of Lipiodol and Adriamycin were infused in 225 patients
and gelfoam embolization were followed in 126 patients. A retrospective analysis for the complications was
undertaken with reviewing of clinical and radiologic findings.
RESULTS: Severe post-embolization syndrome lasting longer than one week developed in 54 patients in whom
Ihe tumor size was mostly larger than 6cm in diameter. Sepsis accompanying persistent fever was developed
in 9 cases. There were various hepatic complications;transient deterioration of hepatic function(46 cases),
persistent deterioration of hepatic function(15 cases), hepatic failure(9 cases), hepatic rupture(3 cases),
intrahepatic bile duct injury(3 cases) and liver abscess(1 case). Complications involuing other organs were
upper GI bleeding(9 cases), gallbladder infarction(3 cases), splenic infarction(4 cases), Pulmonary embolism(6
cases)and spinal arterial embolism(1 case). There were 9 mortalities within one month after the procedure.
CONCLUSION: Various complications of liver and other organs after chemoembolization of hepatic neoplasm
warrants more scrutinized preprocedure evaluations of related factors such as amount of embolic materials,
vascular anatomy, protal invasion, biliary obstruction, and liver functional reservoir.