Liver abscess following ablation therapies for metastatic liver tumor after biliary reconstruction : report of two cases

Two cases of liver abscess following ablation therapies for metastatic liver tumor after biliary reconstruction are reported. Case 1; A 58-year-old man underwent pylorus preserving pancreatoduodenectomy for cholangiocarcinoma. Microwave coagulation therapy was performed for metastatic liver tumor; however, liver abscess developed after one month and became recurrent. Case 2; A 67-year-old woman underwent pylorus preserving pancreatoduodenectomy for periampullary cancer. Radio frequency ablation was performed for metastatic liver tumor; however, liver abscess developed after one week. In Case 1, we believe that cholangitis at the peripheral level of the intrahepatic biliary tree spread to the treated area and altered blood flow caused recurrence of liver abscess.
In Case 2, cholangitis could have been directly transferred to the ablated area through between the abscess and intrahepatic bile duct. In conclusion, ablation therapies could promote the development of liver abscess in patients who have undergone biliary tract reconstruction after tumor resection and might be contraindicated in such patients.