Transarteriyel radyoembolizasyon yapilan hepatosellüler karsinom hastalarinda biliyer komplikasyonlar

Objectives: In this study, we aimed to examine the biliary complications that developed in HCC (Hepatocellular Carcinoma) patients who underwent TARE (Transarterial Radioembolization) and the parameters with which these complications were associated. Material and Methods: 99 HCC patients who underwent TARE at Çukurova University Faculty of Medicine Balcalı Hospital between 2016 and 2020 and a total of 135 procedures needed due to repetitive procedures in the same period were examined. Demographic data of the patients, etiology, size, localization, tumor characteristics such as PVT, medical treatments, laboratory data (AST, ALT, total and direct bilirubin, GGT, albumin, INR, AFP) before and after the procedure (15th day and 3rd month), response evaluation and complications, MR imaging, survival, Y90 doses applied in the procedure, and the relationship between complications and defined parameters were retrospectively analyzed. Results: The mean age of 99 patients included in the study was 65 and of the participants, 90.9% were male and 9% were female. Etiology was HBV in 55.6% and HCV in 20.2%. The 5-year survival rate was found to be 20.9%. The findings from the MRI taken for the evaluation of response after TARE show that of participants, partial response was observed in 41.4% and biliary complications were observed in 20.2%. Biliary complications observed in our patients were signs of expansion in the biliary tract and cholecystitis. Complication rates were lower in patients with NASH (Non- Alcoholic Steatohepatitis), and higher in those diagnosed with HBV (Hepatitis B). Considering the laboratory data obtained after the procedure, an increase in total and direct bilirubin and GGT (Gamma Glutamyl Transferase) values, and a decrease in albumin values were observed. Liver enzymes were significantly higher on the 15th day and did not show a significant difference in the 3rd month compared to the 15th day. GGT levels were paradoxically found to be lower in patients with biliary complications, Conclusion: Biliary tract complications may develop in patients with HCC carcinoma who underwent TARE. An increase in GGT, total, and direct bilirubin values was observed after the procedure, but this increase was associated with REILD (Radioembolization-induced liver disease) rather than a biliary complication. More prospective studies with large number of patiens are needed to understant the reasons and outcomes of patiens with bilary complications. Keywords: Hepatocellular carcinoma, radioembolization, complication, biliary tract, cholesistitis