Intraductal chilled saline perfusion to prevent bile duct injury during percutaneous radiofrequency ablation for hepatocellular carcinoma

Ohnishi, Takaya; Yasuda, Ichiro; Nishigaki, Youichi; Hayashi, Hideki; Otsuji, Kentaro; Mukai, Tsuyoshi; Enya, Mayumi; Omar, Salem; Soehendra, Nib; Tomita, Eiichi; Moriwaki, Hisataka

doi:10.1111/j.1440-1746.2007.05091.x

Cited by 48 publications

(41 citation statements)

References 15 publications

(54 reference statements)

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“…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] . Peripheral stenosis is usually asymptomatic, but central strictures may lead to serious complications.…”

Section: Biliary Tract Damagementioning

confidence: 99%

“…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] .…”

Section: Biliary Tract Damagementioning

confidence: 99%

“…Ohnishi et al [25] reported a method to prevent this complication by infusing intraductal chilled saline solution through an endoscopic nasobiliary drainage tube. Only one patient (2.5%) developed a stricture (left hepatic duct); the 39 remaining subjects were able to avoid thermal injury with this procedure.…”

Section: Skin Burnsmentioning

confidence: 99%

“…Peripheral stenosis is usually asymptomatic, but central strictures may lead to serious complications. These strictures are believed to lead to liver atrophy and its consequent malfunction [25] . This is very important for cirrhotic patients because, due to their already impaired liver function, they may easily develop liver failure and cholangitis after bile duct stenosis [21,25] .…”

Section: Biliary Tract Damagementioning

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: Skin Burnsmentioning

confidence: 99%

Section: Biliary Tract Damagementioning

confidence: 99%

See 2 more Smart Citations

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

Fonseca

Santin

Gomes

et al. 2014

WJH

View full text Add to dashboard Cite

show abstract

“…Ethanol injection is effective to some extent, but the therapeutic effect is limited compared to RFA. For such cases, many institutions including ours employ a method in which an endoscopic nasobiliary drainage tube is inserted into the bile duct, and RFA is performed with cooling by the perfusion of ice-cold water through the tube [49,50]. This procedure markedly reduced the probability of bile duct injury.…”

Section: Advances Of Techniques For Rfa Difficult Casesmentioning

confidence: 99%

Radiofrequency Ablation for Hepatocellular Carcinoma: Updated Review in 2010

Kudo

2010

Oncology

126

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Percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) was introduced in Japan in 1999. It has been established as a main local treatment method worldwide including Japan. On comparing outcomes between resection and RFA, they were comparable when cases were limited to those with 3 or fewer tumors 3 cm or smaller in many reports, based on which RFA has become the main treatment for small HCCs. The 5-year survival rate following RFA was as high as 57% in patients registered in the Liver Cancer Study Group of Japan, 73% when cases were limited to liver damage A (Child-Pugh A), and 83.8 and 76.3% in liver damage A (Child-Pugh A) cases with a single 2-cm or smaller and 2- to 5-cm liver tumor, respectively, showing outcomes equivalent to those of resection. The outcomes at our facility were also favorable: the 5-year survival rates of Child-Pugh A liver function HCC cases with 3 or fewer tumors 3 cm or smaller following RFA and resection were 84 and 78%, respectively. Various complications and limitations of RFA have previously been reported, but the advances of physicians’ skills and development of various techniques have reduced complications and expanded the indications for RAF. TACE-combined, artificial pleural effusion- and ascites-combined, and contrast-enhanced ultrasonography-guided RFAs are good examples. Adjuvant therapy, such as interferon and molecular targeted therapies following curative therapy, is expected to further improve survival after RFA.

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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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Intraductal chilled saline perfusion to prevent bile duct injury during percutaneous radiofrequency ablation for hepatocellular carcinoma

Abstract: ICSP through a nasobiliary tube is a potential intervention method to prevent biliary injury by percutaneous RFA.

Cited by 48 publications

References 15 publications

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

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

Radiofrequency Ablation for Hepatocellular Carcinoma: Updated Review in 2010

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

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