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. 2011 Jun;28(2):230-3.
doi: 10.1055/s-0031-1280671.

Hepatic radioembolization complicated by radiation cholecystitis

Ryan Hickey  1 , Robert J Lewandowski
Affiliations

Hepatic radioembolization complicated by radiation cholecystitis

Ryan Hickey et al. Semin Intervent Radiol. 2011 Jun.

Abstract

Biliary complications following yttrium-90 ((90)Y) radioembolization are rare, and radiation-induced cholecystitis requiring intervention represents an even smaller proportion of these complications, reportedly occurring in fewer than 1% of patients treated with (90)Y [1]. However, its implications are serious, as the treatment of radiation cholecystitis may require cholecystectomy in patients otherwise considered poor surgical candidates. While biliary complications such as intrahepatic biliary strictures or bilomas may be unavoidable in the course of treating hepatic malignancies due to local field effects of radiation, radiation cholecystitis results from non-target embolization of radioactive microspheres. Meticulous attention to anatomic detail and catheter position may be adequate in preventing this avoidable complication. Herein we discuss the clinical, radiographic, and pathologic findings, as well as the outcome, of a patient who experienced radiation cholecystitis following (90)Y radioembolization.

Keywords: Radioembolization; Y90; radiation cholecystitis.

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Figures

Figure 1
Figure 1
Axial contrast-enhanced computed tomography image acquired 3 days following 90Y treatment to both right and left hepatic lobes demonstrating marked gallbladder wall thickening and pericholecystic fluid consistent with acute cholecystitis.
Figure 2
Figure 2
High-powered photomicrograph acquired following laparoscopic cholecystectomy in the same patient approximately 7 weeks later demonstrating fibrosis and chronic inflammatory changes, as well as a glass microsphere (arrow).
See this image and copyright information in PMC

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