Acute pancreatitis induced by transarterial chemoembolization： a single-center experience of over 1500 cases

• Published in: Hepatobiliary & pancreatic diseases international Vol. 15; no. 1; pp. 93 - 98
• Main Authors: She, Wong Hoi, Chan, Albert CY, Cheung, Tan To, Chok, Kenneth SH, Chan, See Ching, Poon, Ronnie TP, Lo, Chung Mau
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.02.2016
• Subjects: Acute Disease; acute pancreatitis; Aged; Aged, 80 and over; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic - adverse effects; Cisplatin - administration & dosage; Cisplatin - adverse effects; Doxorubicin - administration & dosage; Doxorubicin - adverse effects; Endocrinology & Metabolism; Female; Gastroenterology and Hepatology; hepatocellular carcinoma; Hong Kong; Humans; Liver Neoplasms - therapy; Male; Middle Aged; Pancreatitis - chemically induced; Pancreatitis - diagnosis; Pancreatitis - therapy; Retrospective Studies; Time Factors; transarterial chemoembolization; Treatment Outcome; 保守治疗; 化疗; 并发症; 急性胰腺炎; 栓塞; 肝动脉; 肝细胞癌; 诱导; transarterial chemoembolization; hepatocellular carcinoma; acute pancreatitis
• ISSN: 1499-3872
• DOI: 10.1016/S1499-3872(15)60034-0

BACKGROUND： Acute pancreatitis is a relatively rare but po- tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS： A total of 1632 patients with hepatocellular car- cinoma who had undergone transarterial chemoembolization from ]anuary 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com- plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS： Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa- tients was 61 years. Most （79.6%） of the patients suffered from HBV-related hepatoceUular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut- ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven （0.4%） patients suffered from acute pancre- atitis post-chemoembolization. Six patients had chemoembo- lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxornbicin eluting bead had a higher risk of acute pancreatitis [6/145 （4.1%） vs 1/1487 （0.1%）, P〈0.0001]. Two patients had anatomical arterial variations. Four patients developed acute pancreatitis- related complications including necrotizing pancreatitis （n=3） and pseudocyst formation （n=1）. All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication. CONCLUSIONS： Acute pancreatitis after transarterial chemo- embolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of current treatment with transarterial chemoembolization after acute pancreatitis is feasible providing the initial attack is completely resolved.