Preventing intrahepatic infection after ablation of liver tumours in biliary-enteric anastomosis patients.
PURPOSE
To assess the value of bowel preparation plus targeted antibiotics for preventing intrahepatic infections after MWA of liver tumours in BEA patients.


MATERIALS AND METHODS
This retrospective study included 21 patients (divided into two groups) with a history of BEA undergoing ultrasound-guided MWA of liver tumours from November 2008 to June 2014. Group A (n = 10) received single-antibiotic therapy (cefazedone 2 g bid 4, amoxicillin and flucloxacillin sodium 2 g bid 3, levofloxacin 0.5 g qd 3) after ablation, and group B (n = 11) received bowel preparation before ablation plus combined antibiotic therapy (imipenem and cilastatin sodium 1 g 1/12 h, linezolid 0.6 g 1/12 h). Patients were followed for 3 months. Incidences of fever, bacteraemia, and intrahepatic infections were compared, including the duration of fever and length of hospital stay.


RESULTS
Following ablation, in group A, 90% of the patients (9/10) had fever, 60% (6/10) had bacteraemia, 60% (6/10) had liver abscess, and 10% (1/10) had biliary tract infection. In group B, no cases of bacteraemia or intrahepatic infection were reported, and the incidences of fever, bacteraemia, and liver abscess were substantially lower than group A (p = 0.002, 0.004, 0.004). Duration of fever and length of hospital stay were markedly shorter than group A (p = 0.002 0.003).


CONCLUSIONS
Bowel preparation plus targeted antibiotic therapy can significantly reduce the incidences of fever, bacteraemia, and intrahepatic infections in BEA patients undergoing MWA of liver tumours. These preliminary results need to be further validated in randomised trials.
['Tan|Shui-Lian|SL|', 'Yu|Xiao-Ling|XL|', 'Liang|Ping|P|', 'Liu|Fangyi|F|', 'Cheng|Zhigang|Z|', 'Han|Zhi-Yu|ZY|', 'Yu|Jie|J|']
D055011:Ablation Techniques D000328:Adult D000368:Aged D000714:Anastomosis, Surgical D000900:Anti-Bacterial Agents D001424:Bacterial Infections D005260:Female D006801:Humans D008113:Liver Neoplasms D008297:Male D008872:Microwaves D008875:Middle Aged D011183:Postoperative Complications D014057:Tomography, X-Ray Computed
intrahepatic infection liver tumours biliary-enteric anastomosis liver abscess Microwave ablation ultrasound-guided percutaneous