Liver abscess after drug‐eluting bead transarterial chemoembolization for hepatic malignant tumors: Clinical features, pathogenesis, and management

Aim The study aimed to investigate the clinical features, incidence, pathogenesis, and management of liver abscess after drug‐eluting bead transarterial chemoembolization (DEB‐TACE) for primary and metastatic hepatic malignant tumors. Methods From June 2019 to June 2021, patients with liver abscess after DEB‐TACE for primary and metastatic hepatic malignant tumors were reviewed and evaluated at our hospital. Demographic and clinical data, radiological findings, management approaches, and prognosis were retrospectively analyzed. Results In total, 419 DEB‐TACE procedures were carried out in 314 patients with primary and metastatic liver tumors at our medical center. Twelve patients were confirmed to have liver abscesses after DEB‐TACE through clinical manifestations, laboratory investigations, and imaging. In this study, the incidence of liver abscess was 3.82% per patient and 2.86% per DEB‐TACE procedure. After percutaneous drainage and anti‐inflammatory treatments, 10 patients recovered, and the remaining 2 patients died due to direct complications of liver abscess, such as sepsis and multiple organ failure. The mortality rate of liver abscesses after DEB‐TACE was 16.7% (2/12). Conclusion The incidence of liver abscess after DEB‐TACE is relatively high and can have serious consequences, including death. Potential risk factors could include large tumor size, history of bile duct or tumor resection, history of diabetes, small DEB size (100–300 μm). Sensitive antibiotics therapy and percutaneous abscess aspiration/drainage are effective treatments for liver abscess after DEB‐TACE.