• Ichiro Sakamoto, Soji Iwanaga, Kenji Nagaoki, Yojiro Matsuoka, Kazuto Ashizawa, Masataka Uetani, Toshio Fukuda, Tomoaki Okimoto, Sadayuki Okudaira, Katsuhisa Omagari, Kuniaki Hayashi, and Naofumi Matsunaga.
• Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
• AJR Am J Roentgenol. 2003 Jul 1;181(1):79-87.

ObjectiveThe purpose of our study was to discuss the incidence, predisposing factors, and clinical course of intrahepatic biloma after transcatheter arterial chemoembolization for hepatic tumors including hepatocellular carcinoma and metastatic liver tumor.Materials And MethodsNine hundred seventy-two patients with hepatocellular carcinoma (n = 920) or metastatic liver tumor (n = 52) underwent chemoembolization during a 12-year period beginning in January 1989. We retrospectively reviewed the medical records and follow-up radiographs of chemoembolization and analyzed the risk factors associated with the development of intrahepatic biloma.ResultsIntrahepatic biloma developed after chemoembolization in 35 patients (3.6%, 35/972) in our series. The incidence of intrahepatic biloma formation in patients with metastatic liver tumor (9.6%, 5/52) was higher than that in patients with hepatocellular carcinoma (3.3%, 30/920) (p < 0.05, Fisher's exact test). The incidence of intrahepatic biloma formation in patients with hepatocellular carcinoma was statistically higher in patients with main tumor size of less than 5 cm and in those with the presence of intrahepatic bile duct dilatation. Technique-related risk factors such as injection site of drugs, repeated chemoembolization with frequency of less than 3 months, and regimen of chemoembolization significantly influenced the incidence of biloma formation in patients with hepatocellular carcinoma. No patient died of infected biloma or septicemia, but one patient died of hepatic failure 2 months after chemoembolization.ConclusionBiloma formation was significantly more prevalent in the metastatic lesion group than in the hepatocellular carcinoma group. Significant prognostic factors for biloma formation in patients with hepatocellular carcinoma were tumor size of less than 5 cm, bile duct dilatation, proximal injection site, repeated injection with frequency of less than 3 months, and injection of a suspension of anticancer drugs.

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