Laparoscopic debridement of hepatic necrosis after hepatic artery chemoembolization.

Talar Tejirian, Anthony Heaney, Steven D Colquhoun, Nicholas Nissen

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

BACKGROUND AND OBJECTIVES: Hepatic artery chemoembolization (HACE) used to treat neuroendocrine tumors metastatic to the liver has shown both survival benefit and improvement in symptoms. The development of hepatic necrosis after HACE is rare, but the consequences can be devastating. We report the first case of laparoscopic management of extensive hepatic necrosis occurring after HACE. CASE REPORT: A 58-year-old man with neuroendocrine tumor metastatic to the liver underwent HACE in addition to medical management. He had undergone previous biliary stenting for biliary obstruction. After HACE was performed via the right hepatic artery, the patient developed sepsis due to right hepatic lobe infarction. Percutaneous drainage and antibiotics were attempted for 2 months, but hepatic debridement was ultimately required due to repeated drain malfunction and septic complications. Laparoscopic necrosectomy was performed with ease and with little blood loss. The patient quickly recovered without any further infectious complications. CONCLUSION: Infected hepatic necrosis resulting from HACE that fails percutaneous management can be successfully managed with laparoscopic necrosectomy. This report adds to the growing evidence that minimally invasive techniques can be used to manage complicated hepatic conditions.

Original languageEnglish (US)
Pages (from-to)493-495
Number of pages3
JournalJSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Volume11
Issue number4
StatePublished - Oct 1 2007
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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