A case of gangrenous cholecystitis after transarterial chemoembolization with Drug-Eluting Beads

Abstract

A 70-year-old male who was diagnosed with liver cirrhosis caused by the hepatitis B was found in abdominal computed tomography (CT) and an angiography to have multiple hepatic cell carcinoma at medial segment. Transarterial chemoembolization (TACE) had undergone five times, which kept in a stable condition, and sixth TACE was performed using Drug elution beads. Abdominal pain and nausea occurred immediately after the TACE. CT after embolization showed high density area of gallbladder wall which suggested the stagnation of the Drug elution beads. He was diagnosed acute cholecystitis due to embolization of cystic artery, and laparoscopic cholecystectomy was performed. Histopathological examination revealed edema and full-thickness necrosis of gallbladder wall, and embolization with spherical substance in the capillary artery in the wall, which leads to diagnose as gangrenous cholecystitis. The patient was discharged on the eighth day after the operation with a good postoperative course. There are no reports that a patient with gangrenous cholecystitis after use of Drug elution beads, this case is presented together with a review of the literature.