Intrahepatic bile duct dilatation after percutaneous radiofrequency ablation for hepatocellular carcinoma: Impact on patient's prognosis

Yuji Kondo, Shuichiro Shiina, Ryosuke Tateishi, Toru Arano, Koji Uchino, Kennichiro Enooku, Eriko Goto, Hayato Nakagawa, Ryota Masuzaki, Yoshinari Asaoka, Hajime Fujie, Tadashi Goto, Masao Omata, Haruhiko Yoshida, Kazuhiko Koike

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

Abstract

Background: Percutaneous radiofrequency ablation (RFA) has been widely accepted as an alternative to surgery for small hepatocellular carcinoma (HCC). In RFA, a portion of liver tissue surrounding tumour is also ablated to achieve a safety margin. The intrahepatic bile duct may be injured and result in chronic bile duct dilatation upstream of the injured site. However, the impact of such an injury on the overall prognosis has been unclear.Methods: Patients who showed bile duct dilatation following RFA were identified by a retrospective review of imaging studies. Each dilatation was classified as mild (limited to one hepatic subsegment) or severe (affecting two or more subsegments). The relation between the incidence of intrahepatic bile duct dilatation and HCC recurrence or survival was analysed using proportional hazard models.Results: Among 589 consecutive HCC patients treated with RFA, 70 (11.9%) and 21 (3.6%) patients showed mild and severe bile duct dilatation respectively. Patients with severe dilatation, but not those with mild dilatation, had lower survival and higher HCC recurrence than patients without dilatation. Severe dilatation, but not mild dilatation, was significantly associated with death [hazard ratio (HR) 2.17, P=0.035] and recurrence (HR 2.89, P<0.001).Conclusion: Whereas mild bile duct dilatation after RFA is clinically negligible, bile duct dilatation affecting two or more subsegments should be regarded as a complication that may affect the prognosis and should be observed carefully.

Original languageEnglish
Pages (from-to)197-205
Number of pages9
JournalLiver International
Volume31
Issue number2
DOIs
Publication statusPublished - Feb 2011
Externally publishedYes

Keywords

  • Bile duct dilatation
  • Hepatocellular carcinoma
  • Radiofrequency ablation

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