| Purpose: To assess the value of bowel preparation plus targeted antibiotics for preventing intrahepatic infections after microwave ablation of liver tumors in biliary-enteric anastomosis patients.Materials and methods: The study included 21 patients with a prior history of BEA undergoing ultrasound-guided MWA of liver tumors in our department from November 2008 to June 2015. The participants were divided into two groups: group A(n = 10) received conventional single-antibiotic therapy after ablation; group B (n =11) received bowel preparation before ablation plus anti-infective therapy in the periablation period using a targeted combination of antibiotics (imipenem and cilastatin sodium 1 g 1/12 h, linezolid 0.6 g 1/12 h), with the spectrum covering Enterobacter and Enterococcus faecalis/faecium. Patients were followed up for 3 months after ablation therapy. The two groups were compared in terms of the incidences of fever, bacteremia, and intrahepatic infections; the duration of fever; and the length of hospital stay.Results: Following ablation, in group A, 90% of patients (9/10) had fever, 60% (6/10)had bacteremia and 70% (7/10) had intrahepatic infections, which included abscess formation in the ablation zone (60%, 6/10) and biliary tract infection (10%, 1/10). In group B, 18.2% (2/11) patients had fever, but no cases of bacteremia or intrahepatic infection were reported.The difference in the incidences of fever, bacteremia, and liver abscess were all substantially lower in group B than in group A(P = 0.002, 0.004,0.004). Duration of fever and length of hospital stay were markedly shorter in group B than in group A(P = 0.002, 0.003).Conclusions: Bowel preparation plus targeted antibiotic therapy can significantly reduce the incidences of fever, bacteremia, and intrahepatic infections in BEA patients undergoing MWA of liver tumors. These preliminary results need to be further validated in randomized trials. |
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