<b>Changes in Bile Ducts after Radiofrequency Ablation of Hepatocellular Carcinoma:</b> Frequency and Clinical Significance

Kim, Seong Hyun; Lim, Hyo Keun; Choi, Dongil; Lee, Won Jae; Kim, Seung Hoon; Kim, Min Ju; Lee, Soon Jin; Lim, Jae Hoon

doi:10.2214/ajr.183.6.01831611

Cited by 70 publications

(49 citation statements)

References 34 publications

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“…Its incidence can be as low as 0.1% and up to 12% [9,12,25,26] . Bile ducts changes are expected and most of these changes have no clinical significance with the patient being asymptomatic with low rates of progression [9,12,26] . This explains its low and underestimated frequency since authors ignore those minor changes [12,26] .…”

Section: Biliary Tract Damagementioning

confidence: 99%

“…Bile ducts changes are expected and most of these changes have no clinical significance with the patient being asymptomatic with low rates of progression [9,12,26] . This explains its low and underestimated frequency since authors ignore those minor changes [12,26] . In a paper studying this matter, most of these changes seen on CT were mild dilatation of the upstream intrahepatic bile duct surrounding the ablation zone [26] .…”

Section: Biliary Tract Damagementioning

confidence: 99%

“…This explains its low and underestimated frequency since authors ignore those minor changes [12,26] . In a paper studying this matter, most of these changes seen on CT were mild dilatation of the upstream intrahepatic bile duct surrounding the ablation zone [26] . The authors did not mention the distance between the tumors and major bile ducts and stated that these changes are irreversible.…”

Section: Biliary Tract Damagementioning

confidence: 99%

“…Biliary stricture is the most common complication in this group [12] . It may develop weeks to several months after RFA [26] . In a study where 28 high-risk patients were analyzed, the incidence of stenosis in this specific group of subjects increased up to 46% (13/28 patients with tumors closer than 5 mm to central bile duct on CT) [25] .…”

Section: Biliary Tract Damagementioning

confidence: 99%

“…Patient selection is vital to avoid this type of complication. Biloma is also encountered in this group of complications, with an incidence ranging from 0.1% to 5.8% [6,12,26,30] . It is defined as an encapsulated bile collection outside the biliary tree due to biliary leakage.…”

Section: Skin Burnsmentioning

confidence: 99%

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Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Fonseca

Santin

Gomes

et al. 2014

WJH

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Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient's co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician's experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes.

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Section: Biliary Tract Damagementioning

confidence: 99%

Section: Biliary Tract Damagementioning

confidence: 99%

Section: Biliary Tract Damagementioning

confidence: 99%

Section: Biliary Tract Damagementioning

confidence: 99%

Section: Skin Burnsmentioning

confidence: 99%

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Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Fonseca

Santin

Gomes

et al. 2014

WJH

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Imaging review of hepatocellular carcinoma after thermal ablation: The good, the bad, and the ugly

Bouda

Lagadec

Alba

et al. 2016

Magnetic Resonance Imaging

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Image-guided thermal ablation is a well-established locoregional technique for the treatment of hepatocellular carcinoma (HCC). HCC surveillance programs have led to an increase in the number of patients diagnosed at an early stage of the disease who are eligible for thermal ablation. Tumor response is assessed on imaging and requires extensive follow-up; thus, radiologists play a key role in defining the technical success and efficacy of treatment as well as identifying progressive disease. Although they are rare, complications, such as secondary infections, must also be identified. Several contrast-enhanced imaging techniques can be used at different postprocedural timepoints but magnetic resonance imaging (MRI) and computed tomography (CT), which allow both liver-centered and whole-body imaging are the cornerstones of follow-up. This review describes the imaging features of HCC following thermal ablation. After describing the basic technical elements of follow-up imaging, imaging findings are divided into three groups: normal and expected features (the good), abnormal features, uncontrolled disease, and complications (the bad), and atypical or rare presentations (the ugly). J. Magn. Reson. Imaging 2016;44:1070-1090.

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Hepatic Ablation: Hepatocellular Carcinoma and Metastases

Winokur

Brown

2012

Interventional Radiology Techniques in Ablation

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Changes in Bile Ducts after Radiofrequency Ablation of Hepatocellular Carcinoma: Frequency and Clinical Significance

Abstract: Although bile duct changes were frequent after the radiofrequency ablation of hepatocellular carcinoma, most were of no clinical significance, and major complications requiring additional treatment were rare.

Cited by 70 publications

References 34 publications

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Imaging review of hepatocellular carcinoma after thermal ablation: The good, the bad, and the ugly

Hepatic Ablation: Hepatocellular Carcinoma and Metastases

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