Seong Sook Hong MD, Presenter: Nothing to Disclose

Pyo Nyun Kim MD, Abstract Co-Author: Nothing to Disclose

Yong Moon Shin MD, Abstract Co-Author: Nothing to Disclose

Jae Ho Byun MD, Abstract Co-Author: Nothing to Disclose

Hyung Jin Won MD, Abstract Co-Author: Nothing to Disclose

To report of biliary complication after radiofrequency ablation in hepatic tumors and to evaluate their risk factor and clinical impact.

Between Feb. 2000 and Nov. 2003, 736 patients with 1262 hepatic tumors (950 hepatocellular carcinomas, 35 cholangiocarcinomas, 88 metastases, 183 dysplastic nodules, 3 cholangiohepatocelluar carcinomas, and 3 others) underwent radiofrequency ablation using single or cluster cool-tip needle. We reviewed the immediate and follow up post-ablation CT, laboratory data, and post-ablation clinical course. We also analyzed the number and characteristics of biliary complication after radiofrequency ablation. Data were analyzed to determine whether the biliary complication rate was related to the tumor location, the tumor size, or the ablation number of each session.

Biliary complications occurred in 30 (3.1%) of 983 sessions and 30 (4.1%) of 736 patients. Bile duct dilatation was seen on CT in 24 patients (2.4%), pneumobilia in one patient, biloma in the ablated zone in one patient, GB wall thickening in three patients, and perorated GB in one patient. The immediate appearance of bile duct dilatation was seen on follow up CT in 14 patients. Four patients among them were underwent PTBD or pigtail insertion due to hyperbilirubinemia. Three patients with GB wall thickening (except perforated one) had no requiring specific treatments during the follow-up period. The mean diameter (2.98±1.51cm) of tumor in patients with biliary complication was significantly larger than that (2.25±1.16cm) of tumor in patients without biliary complication (P<0.05). An Increased ablation number at the each session were related to a higher rate of biliary complication (P<0.05). In nineteen (79.2%) of 24 patients with bile duct dilatation, pre-treated tumors was located at adjacent confluent portion of bile duct (within 2cm), or abutted within second order branch of main portal vein.

Symptomatic biliary complication after radiofrequency ablation in hepatic tumors is a relatively low, But, careful consideration of biliary complication should be needed to treat large or central tumors adjacent confluent portion of bile duct and/or large major vessels.

Hong, S, Kim, P, Shin, Y, Byun, J, Won, H, Biliary Complication after Radiofrequency Ablation of Hepatic Tumors; Frequency, Risk Factor, and Clinical Impact.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4411852.html