Chen YF, Lin ZY, Chen LT, Zhang Y, Du ZQ. Cystic artery embolism after transarterial chemoembolization for hepatocellular carcinoma: A case report and review of the literature. World J Gastrointest Oncol 2025; 17(3): 99129 [DOI: 10.4251/wjgo.v17.i3.99129]
Corresponding Author of This Article
Zhao-Qing Du, MD, PhD, Academic Researcher, Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, No. 256 West Youyi Road, Xi’an 710068, Shaanxi Province, China. duzhaoqing2007@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2025; 17(3): 99129 Published online Mar 15, 2025. doi: 10.4251/wjgo.v17.i3.99129
Cystic artery embolism after transarterial chemoembolization for hepatocellular carcinoma: A case report and review of the literature
Yi-Fan Chen, Zhen-Yi Lin, Lin-Tao Chen, Yu Zhang, Zhao-Qing Du
Yi-Fan Chen, Zhen-Yi Lin, Lin-Tao Chen, Yu Zhang, Zhao-Qing Du, Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Yi-Fan Chen, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
Zhen-Yi Lin, Medical Student, 10 Medical Dr, Singapore 117597, Singapore
Lin-Tao Chen, Xizang Minzu University, Xianyang 712082, Shaanxi Province, China
Zhao-Qing Du, National Engineering Research Center for Miniaturized Detection Systems, College of Life Science, Northwest University of Xi'an, Xi'an 710069, Shaanxi Province, China
Co-first authors: Yi-Fan Chen and Zhen-Yi Lin.
Author contributions: Chen YF, Lin ZY, and Du ZQ wrote and designed the case report, and reviewed the literature; Chen LT, Zhang Y, and Du ZQ were the attending doctors for the patient and contributed the resources and supervision. All authors read and approved the final manuscript. Chen YF and Lin ZY contributed equally to this work as co-first authors.
Supported by National Natural Science Foundation of China, No. 82200686; and Shaanxi Provincial People's Hospital Incubation Project, No. 2022YJY-14.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Qing Du, MD, PhD, Academic Researcher, Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, No. 256 West Youyi Road, Xi’an 710068, Shaanxi Province, China. duzhaoqing2007@126.com
Received: July 14, 2024 Revised: November 22, 2024 Accepted: December 19, 2024 Published online: March 15, 2025 Processing time: 214 Days and 21 Hours
Abstract
BACKGROUND
Acute cholecystitis due to unintended cystic artery embolism is an uncommon and mostly self-limiting complication after transarterial chemoembolization procedure for treatment of hepatocellular carcinoma. Usually, conservative management is sufficient for complete recovery of patients who develop this complication. If conservative treatment is ineffective, urgent surgical intervention may be required to prevent the progression of complications.
CASE SUMMARY
This article reports a rare and serious case of acute cholecystitis complicated by gallbladder necrosis and biliary peritonitis, which was initially treated conservatively but eventually necessitated emergency laparotomy. The patient initially presented with equivocal symptoms of fever and upper abdominal pain and distention, which worsened at the two weeks mark along with emergence of signs of peritonitis. This was managed by emergency laparotomy and cholecystostomy, allowing rapid symptom relief. The patient ultimately discharged and succumbed to advanced liver cancer 11 months after diagnosis.
CONCLUSION
After cholecystostomy, the patient showed symptom relief and was discharged, surviving 11 months post-stage IIIB liver cancer diagnosis.
Core Tip: Acute cholecystitis due to cystic artery embolism after transarterial chemoembolization is an uncommon and mostly self-limiting complication. We present a rare case of acute cholecystitis complicated by gallbladder necrosis and biliary peritonitis, which required emergency laparotomy and cholecystostomy creation.
