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CardioVascular and Interventional Radiology

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01.08.2015 | Clinical Investigation

Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

verfasst von: Shivank S. Bhatia, Seth Spector, Ana Echenique, Tatiana Froud, Rekha Suthar, Ivy Lawson, Ravi Dalal, Vy Dinh, Jose Yrizarry, Govindarajan Narayanan

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 4/2015

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Abstract

Purpose

The purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.

Materials and Methods

From January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.

Results

One patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.

Conclusion

These data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis.

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Titel: Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience
verfasst von: Shivank S. Bhatia
Seth Spector
Ana Echenique
Tatiana Froud
Rekha Suthar
Ivy Lawson
Ravi Dalal
Vy Dinh
Jose Yrizarry
Govindarajan Narayanan
Publikationsdatum: 01.08.2015
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 4/2015
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-014-1020-0

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Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience