Analysis Of 11 Cases Of Liver Abscess Formation After Hepatic Artery Ligation(Embolism)

Objective: To study the mechanism,diagnosis and treatment of liver abscess formation after hepatic artery ligation (embolism) .Methods: The data of 11 cases of liver abscess formation after hepatic artery ligation ( embolism) were gathered and analyzed retrospectively from January ,2001 to June ,2008.Results: Among the 11 cases, there are 4 cases of hilar bile duct carcinoma,4 cases of bilecellular carcinomas,1 case of heptic metastasis after operation for cancer of colon,2 cases of carcinomas of head of pancreas. Left hepatic artery was ligated in 1 case, right hepatic artery in 4 cases, proper hepatic artery in 4 cases and proper hepatic artery was embolismed in 2 cases. Biliary-intestinal anastomosis was performed in 9 cases. Liver abscess developed in all the 11 cases. The time of liver abscess development was 6-22 days after operation. Treated with sonographic guided percutaneous puncture for clearing pus in coordination with sensitive antibiotics,liver function preservation and high nutrition support, 9 cases were cured and multiple liver abcess took place in the other 2 repeatedly.Conclusions: Hepatic artery ligation is of great importance to liver abscess formation. The mechanism is related with the ischemia,anoxia and necrosis of cells of bile duct epithelia caused by hepatic artery ligation, which leads to infection and necrosis of a big area of liver tissue, especially in patients with biliary-intestine anastomosis or cancerous embolus in portal vein. Hepatic artery should be reserved as far as possible during operation. If invaded, hepatic artery reconstruction should be performed. To those whose hepatic artery is severely invaded and of which the distal terminal is totally blocked, hepatic artery reconstruction is unavailable and some other types of artery reconstruction like portal vein arterialization (PVA) could be performed to guarantee the blood supply of liver tissue as well as bile duct cells. Once hepatic abscess formed, sonographic guided percutaneous puncture drainage in coordination with sensitive antibiotics,liver function preservation and high nutrition support is an effective measurement.