Successful treatment of radiofrequency-induced biliary lesions by interventional endoscopic retrograde cholangiography (ERC).
BACKGROUND
Radiofrequency ablation (RFA) of malignant liver lesions is considered a procedure with low morbidity. However, RFA performed close to hilar structures carries the risk of heat-induced biliary tract damage and subsequent septic episodes.


METHODS
We performed an analysis of complications in 42 patients with 211 liver lesions treated with a combined approach of liver resection and RFA.


RESULTS
One patient died due to postoperative liver failure. There was one case of temporary liver dysfunction, one vena cava thrombosis, and six febrile episodes. Four of the six febrile episodes were related to bile duct injuries. They became evident 3-5 weeks after the procedure. All four patients were treated successfully by the placement of stents within the biliary tract. None of the patients developed a hepatic abscess.


CONCLUSIONS
Biliary tract damage is a complication that can occur weeks after RFA. Immediate endoscopic intervention can obviate the occurrence of prolonged septic complications.
Department of Visceral and Vascular Surgery, University of Cologne, Joseph Stelzmann Strasse 9, 50931 Cologne, Germany. Dirk.Stippel@uni-koeln.de
D L
DL
Stippel
U
U
Töx
A
A
Gossmann
K T E
KT
Beckurts
A H
AH
Hölscher
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000293:injuries*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D017093:Liver Failure / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome; D014682:Vena Cava, Inferior
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil