Prevention of biliary complication in radiofrequency ablation for hepatocellular carcinoma-Cooling effect by endoscopic nasobiliary drainage tube

Tsuneyoshi Ogawa, Hirofumi Kawamoto, Yoshiyuki Kobayashi, Shinichiro Nakamura, Hirokazu Miyatake, Ryo Harada, Koichiro Tsutsumi, Masakuni Fujii, Naoko Kurihara, Hironari Katou, Ken Hirao, Osamu Mizuno, Etsuji Ishida, Hiroyuki Okada, Kazuhide Yamamoto

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Abstract

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.

Original languageEnglish
Pages (from-to)385-390
Number of pages6
JournalEuropean Journal of Radiology
Volume73
Issue number2
DOIs
Publication statusPublished - Feb 2010

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Keywords

  • Endoscopic nasobiliary drainage tube
  • Hepatocellular carcinoma
  • Prevention of biliary complication
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Ogawa, T., Kawamoto, H., Kobayashi, Y., Nakamura, S., Miyatake, H., Harada, R., Tsutsumi, K., Fujii, M., Kurihara, N., Katou, H., Hirao, K., Mizuno, O., Ishida, E., Okada, H., & Yamamoto, K. (2010). Prevention of biliary complication in radiofrequency ablation for hepatocellular carcinoma-Cooling effect by endoscopic nasobiliary drainage tube. European Journal of Radiology, 73(2), 385-390. https://doi.org/10.1016/j.ejrad.2008.10.021