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Bile Duct Injuries Leading to Portal Vein Obliteration after Transcatheter Arterial Chemoembolization in the Liver: CT Findings and Initial Observations

 Jeong-Sik Yu  ;  Ki Whang Kim  ;  Mi-Suk Park  ;  Sang-Wook Yoon 
 RADIOLOGY, Vol.221(2) : 429-436, 2001 
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Adult ; Bile Ducts/injuries* ; Catheterization ; Chemoembolization, Therapeutic/adverse effects* ; Female ; Follow-Up Studies ; Humans ; Liver ; Male ; Middle Aged ; Portal Vein/injuries* ; Retrospective Studies ; Tomography, X-Ray Computed*
PURPOSE: To document the computed tomographic (CT) findings of transcatheter arterial chemoembolization (TACE)-induced, localized bile duct injuries leading to portal vein branch obliteration in the liver and to elucidate the clinical implications with retrospective review of the authors' experiences. MATERIALS AND METHODS: Follow-up CT scans obtained in 11 patients with TACE-induced intrahepatic bile duct dilatation were reviewed retrospectively to evaluate serial changes in the adjacent portal vein branches and hepatic parenchyma. Clinical data, including time between TACE and CT and serum alkaline phosphatase levels, also were analyzed. RESULTS: Of 11 patients with marked (n = 8) or mild (n = 3), lobar (n = 4) or segmental (n = 7) bile duct dilatation with or without bile collection in the tissue sheaths of the Glisson capsule or hepatic parenchyma, nine (82%) had bile duct changes at the first CT follow-up, within 1 month after TACE. Marked narrowing or obliteration of the adjacent intrahepatic portal vein branches in 10 (91%) patients resulted in progressive atrophy of the corresponding hepatic parenchyma in nine (82%) at variable times after TACE. The serum alkaline phosphatase level increased to more than 200 U/L in eight (89%) of nine patients 1 month after TACE. CONCLUSION: TACE-induced intrahepatic bile duct injury resulting in obliteration of the adjacent portal vein branch seems to be one cause of hepatic parenchymal atrophic changes after TACE.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
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