Risk Factors for Bile Duct Injury After Percutaneous Thermal Ablation of Malignant Liver Tumors: A Retrospective Case–Control Study

Lin, Manxia; Ye, Jieyi; Tian, Wei; Xu, Ming; Zhuang, Bowen; Lu, Ming-De; Xie, Xiaoyan; Kuang, Ming

doi:10.1007/s10620-016-4312-1

Cited by 19 publications

(19 citation statements)

References 35 publications

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“…It’s worth noting that the distance between the tumor and adjacent hilar bile ducts has highly important consequences on the therapeutic effect of RFA. Lin et al reported that a distance from the bile duct within 10 mm was thought to be a high-risk factor for ablation-related biliary complications for HCC nodules ( 30 ). RFA is still not recommended for application in HCC nodules adjacent to the HBDs in some clinical treatment guidelines of HCC ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Improving Ablation Safety for Hepatocellular Carcinoma Proximal to the Hilar Bile Ducts by Ultrasound-MR Fusion Imaging: A Preliminary Comparative Study

et al. 2021

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AimTo explore whether ablation safety could be improved by ultrasound (US)-magnetic resonance (MR) fusion imaging for hepatocellular carcinoma (HCC) proximal to the hilar bile ducts (HBDs) through a preliminary comparative study.MethodsBetween January 2014 and June 2019, 18 HCC nodules proximal to the HBDs were included in a US-MR fusion imaging-assisted radiofrequency ablation (RFA) group (study group), while 13 HCC nodules in a similar location were included as a control group. For the study group, the tumor and adjacent bile ducts were outlined on preprocedural MR images. Procedural ablation planning was conducted to assess the feasibility of ablating the tumors while avoiding biliary injury. Such tumors were then ablated under US-MR fusion imaging guidance. The control group nodules were ablated under conventional ultrasound guidance. Baseline characteristics and outcomes were compared between the groups.ResultsAfter preprocedural assessment, 14 of 18 patients with tumors that were feasible to ablate underwent US-MR fusion imaging-assisted RFA. No biliary complications were observed in these 14 patients; the complication rate was significantly lower in the study group than in the control group (30.8%, 4/13) (P = 0.041). There was no significant difference in the technique efficacy rates [92.9% (13/14) versus 100% (13/13), P = 1] or local progression rates [7.1% (1/14) versus 7.7% (1/13), P = 1] between the study and control groups.ConclusionsUS-MR fusion imaging may be a non-invasive means for assisting RFA of HCC nodules proximal to the HBDs and ensuring ablation safety.

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Section: Discussionmentioning

confidence: 99%

Improving Ablation Safety for Hepatocellular Carcinoma Proximal to the Hilar Bile Ducts by Ultrasound-MR Fusion Imaging: A Preliminary Comparative Study

et al. 2021

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“…No local tumor progression was noted during the 29-month follow-up period. Previous studies have reported that the percutaneous thermal ablation of tumors close to the bile duct (within 10 mm) cause bile duct injury [12,13]. In one study [14], bile duct dilatation after RFA worsened prognosis as patients with severe dilatation in two or more bile duct segments showed lower survival and higher HCC recurrence than patients without this complication.…”

Section: Discussionmentioning

confidence: 98%

“…Tumor location should be considered for the successful and safe local ablation of HCCs. The management of periductal HCCs by RFA is challenging because thermal injury to the bile duct can result in biliary complications such as bile duct stricture and hepatic biloma [11][12][13]. In addition, central bile duct injury can severely impair liver function and lead to poor prognosis [14].…”

Section: Introductionmentioning

confidence: 99%

Comparison of procedure-related complications between percutaneous cryoablation and radiofrequency ablation for treating periductal hepatocellular carcinoma

Lee

Rhim

et al. 2020

International Journal of Hyperthermia

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“…Although some of the heat is removed by blood flow, the size of the affected area is still approximately 12–15 mm in diameter when 3 W of power is used for 10 min and is well demarcated, accurate and partly dependent on the duration of the illumination time. Heat injury to adjacent bile ducts is commonly encountered with thermal ablation because bile flow is slow and has a negligible cooling effect in contrast to blood flow, and it has been demonstrated to be associated with the distance between the tumor and bile duct . Nevertheless, bile duct damage with the PLA of tumors in the liver hilum is much lower than that reported with RFA and PEI because the laser light is rapidly decayed from the center to the periphery so that the possibility of thermo‐damage to adjacent critical structures would be reduced .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Laser Ablation of Hepatic Tumors Located in the Portacaval Space: Preliminary Results

2019

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Background and Objectives Limited data have been used to evaluate the feasibility and effectiveness of percutaneous laser ablation (PLA) (a modality that has been proven to be a safe method for tumors in high‐risk locations) for hepatic tumors in the space between the portal vein and inferior vena cava (IVC). The goal of this study was to investigate the characteristics and therapeutic effectiveness of ultrasound‐guided PLA of hepatic tumors in the portacaval space. Study Design/Materials and Methods Ten patients, who had hepatic tumors in the portacaval space (defined as tumors located in the space formed by the hepatic portal vein and IVC less than 5 mm from the margins of both vessels), receiving ultrasound‐guided PLA between January 2016 and June 2017 were analyzed. Tumors in the type I portacaval space were enclosed on three sides of major vessels, and tumors in the type II portacaval space were enclosed on two sides of major vessels. The technical success, treatment response, complete tumor ablation (CTA), local tumor progression (LTP), and distant tumor recurrence (DTR) were assessed and recorded at the follow‐up. Results The mean tumor diameter was 1.8 ± 0.4 cm. Technical success and initial CTA were achieved in all 10 patients without major complications. The 6‐month and 12‐month LTP rates were 0% and 10%, respectively. The DTR rate was 20% at both the 6‐ and 12‐month follow‐ups. Conclusions The preliminary results showed that ultrasound‐guided PLA was feasible and safe for tumors in the portacaval space, and further studies on larger populations with a longer follow‐up are needed to delineate the use of PLA and evaluate its therapeutic efficacy. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Risk Factors for Bile Duct Injury After Percutaneous Thermal Ablation of Malignant Liver Tumors: A Retrospective Case–Control Study

Abstract: Bile duct injury after ablation of MLTs was the result of local treatment-related factors combined with the patients' general condition. The minimum safe distance for ablation of tumor abutting a bile duct was 10 mm.

Cited by 19 publications

References 35 publications

Improving Ablation Safety for Hepatocellular Carcinoma Proximal to the Hilar Bile Ducts by Ultrasound-MR Fusion Imaging: A Preliminary Comparative Study

Improving Ablation Safety for Hepatocellular Carcinoma Proximal to the Hilar Bile Ducts by Ultrasound-MR Fusion Imaging: A Preliminary Comparative Study

Comparison of procedure-related complications between percutaneous cryoablation and radiofrequency ablation for treating periductal hepatocellular carcinoma

Percutaneous Laser Ablation of Hepatic Tumors Located in the Portacaval Space: Preliminary Results

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