Successful treatment of radiofrequency-induced biliary lesions by interventional endoscopic retrograde cholangiography (ERC)

Surg Endosc. 2003 Dec;17(12):1965-70. doi: 10.1007/s00464-002-9273-0. Epub 2003 Oct 28.

Abstract

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.

Conclusion: Biliary tract damage is a complication that can occur weeks after RFA. Immediate endoscopic intervention can obviate the occurrence of prolonged septic complications.

Publication types

  • Case Reports
  • Evaluation Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biliary Tract / diagnostic imaging
  • Biliary Tract / injuries*
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / surgery
  • Catheter Ablation / adverse effects*
  • Chemotherapy, Adjuvant
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Colorectal Neoplasms / pathology
  • Combined Modality Therapy
  • Fatal Outcome
  • Female
  • Fever / etiology
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Humans
  • Leucovorin / administration & dosage
  • Liver Failure / etiology
  • Liver Neoplasms / complications
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Liver Neoplasms / therapy
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local
  • Organoplatinum Compounds
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Postoperative Complications / surgery*
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Stents
  • Thrombosis / etiology
  • Treatment Outcome
  • Vena Cava, Inferior

Substances

  • Organoplatinum Compounds
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol