Table 1. Clinical findings of 12 patients with a history of biliary manipulation prior to thermal ablation of liver lesion(s).
Patient no. | Age (years) | Sex (M/F) | Primary tumor | Type of surgery causing biliary violation | Biliary manipulation to ablation (years) | Size of tumors (cm) | Thermal ablation modality | Previous TACE? | Antibiotic prophylaxis | Post-ablation abscess (yes/no) |
---|---|---|---|---|---|---|---|---|---|---|
1 | 78 | F | GIST | PD | 10.0 | 0.8 | MWA | No | APARa | No |
2 | 64 | F | PDAC | PD | 1.0 | 2 | RFA | No | APARa | No |
3 | 69 | M | Pancreatic NET | PD | 3.6 | 1.8 | MWA | No | APARa | No |
4 | 71 | F | LMS | PD | 1.7 | 2.5 | MWA | No | APARa | No |
5 | 42 | F | Ampullary carcinoma | PD | 1.5 | 1.8 | MWA | No | APARa | No |
6 | 54 | M | Pancreatic NET | PD | 0.8 | 1.2 | MWA | No | APARa | No |
7 | 72 | M | Pancreatic NET | PD | 16.5 | 1.7 | RFA | No | APARa | No |
8 | 65 | F | Pancreatic NET | PD | 2.0 | 1.0 | MWA | No | APARab | No |
9 | 65 | M | Ampullary carcinoma | PD | 2.9 | 1.4 | Cryo | No | APARa | No |
10 | 37 | M | Small bowel carcinoma | PD | 0.5 | 1.1 | MWA | No | APARa | No |
11 | 64 | F | Pancreatic NET | PD | 3.5 | (a) 1.8 (b)3.5 | (a) RFA (b)RFA | Yes | Other regimenc | Yes |
12 | 76 | M | PDAC | PD | 2.1 | 2.5 | MWA | No | Other regimend | Yes |
TACE transarterial chemoembolization, GIST gastrointestinal stromal tumor, PD pancreaticoduodenectomy, MWA microwave ablation, APAR aggressive prophylactic antibiotic regimen, PDAC pancreatic ductal adenocarcinoma, RFA radiofrequency ablation, NET neuroendocrine tumor, LMS leiomyosarcoma, Cryo cryoablation
APAR: Levofloxacin 500 mg orally daily and metronidazole 500 mg orally every 12 h beginning 2 days before the procedure and continuing for 14 days after the procedure; neomycin 1 g orally and erythromycin base 1 g orally at 1, 2, and 11 pm the day before the ablation
Patient was unable to complete antibiotic regimen because of antibiotic-related adverse events
Piperacillin/tazobactam 4.5 g intravenously four times a day plus metronidazole 500 mg intravenously twice daily within 1 h of procedure on the day of the procedure followed by ciprofloxacin and metronidazole 500 mg orally each twice a day for 7 days
Metronidazole 500 mg orally twice a day within 1 h of the procedure for 10 days