TY - JOUR
T1 - Prevention of biliary complication in radiofrequency ablation for hepatocellular carcinoma-Cooling effect by endoscopic nasobiliary drainage tube
AU - Ogawa, Tsuneyoshi
AU - Kawamoto, Hirofumi
AU - Kobayashi, Yoshiyuki
AU - Nakamura, Shinichiro
AU - Miyatake, Hirokazu
AU - Harada, Ryo
AU - Tsutsumi, Koichiro
AU - Fujii, Masakuni
AU - Kurihara, Naoko
AU - Kato, Hironari
AU - Hirao, Ken
AU - Mizuno, Osamu
AU - Ishida, Etsuji
AU - Okada, Hiroyuki
AU - Yamamoto, Kazuhide
PY - 2010/2
Y1 - 2010/2
N2 - Background and study aims: Biliary stricture after radiofrequency ablation (RFA) for nodules of hepatocellular carcinoma (HCC) close to major bile ducts sometimes causes septic complications and liver failure. Therefore, it may require interventional drainage for decompression during the follow-up period. The purpose of this study is to clarify the feasibility and safety of bile duct cooling using an endoscopic nasobiliary drainage (ENBD) tube in RFA for HCC close to major bile ducts. Patients and methods: Between August 2003 and July 2007, 14 consecutive patients (14 nodules) undergoing RFA with cooling by an ENBD tube for HCCs close to major bile ducts were enrolled in this study. We infused chilled saline solution via the ENBD tube at 1 ml/s to prevent heat damage during RFA. As controls, 11 patients (13 nodules) undergoing RFA without cooling close to major bile ducts between April 2001 and August 2003 were reviewed. The major outcomes for evaluation were biliary complications and the secondary outcome was local tumor recurrence. Results: There were no significant differences in tumor recurrence between the two groups. However, the rate of biliary complications was significantly lower in the cooling group than in the non-cooling group (0% vs. 39%, P = 0.02). Conclusions: Cooling of bile ducts via an ENBD tube can prevent biliary complications induced by RFA of HCC close to major bile ducts without increasing local recurrence. This technique increases indication of RFA in difficult cases.
AB - Background and study aims: Biliary stricture after radiofrequency ablation (RFA) for nodules of hepatocellular carcinoma (HCC) close to major bile ducts sometimes causes septic complications and liver failure. Therefore, it may require interventional drainage for decompression during the follow-up period. The purpose of this study is to clarify the feasibility and safety of bile duct cooling using an endoscopic nasobiliary drainage (ENBD) tube in RFA for HCC close to major bile ducts. Patients and methods: Between August 2003 and July 2007, 14 consecutive patients (14 nodules) undergoing RFA with cooling by an ENBD tube for HCCs close to major bile ducts were enrolled in this study. We infused chilled saline solution via the ENBD tube at 1 ml/s to prevent heat damage during RFA. As controls, 11 patients (13 nodules) undergoing RFA without cooling close to major bile ducts between April 2001 and August 2003 were reviewed. The major outcomes for evaluation were biliary complications and the secondary outcome was local tumor recurrence. Results: There were no significant differences in tumor recurrence between the two groups. However, the rate of biliary complications was significantly lower in the cooling group than in the non-cooling group (0% vs. 39%, P = 0.02). Conclusions: Cooling of bile ducts via an ENBD tube can prevent biliary complications induced by RFA of HCC close to major bile ducts without increasing local recurrence. This technique increases indication of RFA in difficult cases.
KW - Endoscopic nasobiliary drainage tube
KW - Hepatocellular carcinoma
KW - Prevention of biliary complication
KW - Radiofrequency ablation
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U2 - 10.1016/j.ejrad.2008.10.021
DO - 10.1016/j.ejrad.2008.10.021
M3 - Article
C2 - 19056192
AN - SCOPUS:76349086195
VL - 73
SP - 385
EP - 390
JO - European Journal of Radiology
JF - European Journal of Radiology
SN - 0720-048X
IS - 2
ER -