Changes in bile ducts after radiofrequency ablation of hepatocellular carcinoma: frequency and clinical significance.
OBJECTIVE
The purpose of our study was to determine the frequency of bile duct changes after radiofrequency ablation for hepatocellular carcinoma and to evaluate their clinical significance.


METHODS
Between April 1999 and August 2003, 389 patients with 521 hepatocellular carcinomas underwent a total of 571 sessions of radiofrequency ablation. The maximum dimension of the tumors measured on sonography was 2.4 +/- 0.9 cm (mean +/- SD) (range, 0.5-5.0 cm). The frequency and type of bile duct changes resulting from radiofrequency ablation, the time interval between radiofrequency ablation and the first appearance of bile duct changes, and the serial changes at follow-up CT were analyzed. Complications related to bile duct changes were also evaluated by reviewing medical records and CT scans.


RESULTS
Bile duct changes occurred in 69 (12%) of 571 sessions and 66 (17%) of 389 patients. Bile duct changes seen on CT included mild dilatation of upstream bile ducts surrounding the ablation zone in 57 patients (82.6%), biloma in the ablation zone in four patients (5.8%), and both in eight patients (11.6%). The mean time interval between radiofrequency ablation and the initial appearance of bile duct change was 1.6 months (range, immediate-9 months). Most (87%) of the 69 patients with bile duct changes showed no progression on follow-up CT, and only nine (13%) had slight progression. All patients but one, in whom cholangitis developed, had no major complications requiring specific treatment during the follow-up period.


CONCLUSIONS
Although bile duct changes were frequent after the radiofrequency ablation of hepatocellular carcinoma, most were of no clinical significance, and major complications requiring additional treatment were rare.
Kim
Seong Hyun
SH
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-ku, Seoul 135-710, South Korea.
Lim
Hyo K
HK
Choi
Dongil
D
Lee
Won Jae
WJ
Kim
Seung Hoon
SH
Kim
Min Ju
MJ
Lee
Soon Jin
SJ
Lim
Jae Hoon
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional