Abstract：
OBJECTIVE: This study aimed to evaluate the incidence and clinical implications of bile duct changes following multibipolar radiofrequency ablation (mbpRFA) for hepatocellular carcinoma (HCC).
METHODS: Radiological, clinical, and biological data from consecutive cirrhotic patients who underwent first-line mbpRFA between 2007 and 2014 for uninodular HCC ≤ 5 cm were retrospectively collected. Follow-up imaging was reviewed to identify bile duct changes and factors associated with biliary changes were assessed using multivariable analysis. Baseline and 6-month liver function tests were compared in patients with and without bile duct changes. Complications, cirrhosis decompensation, and survival rates were compared in both groups.
RESULTS: A total of 231 patients (mean age 68 years [39-85], 187 men) underwent 266 mbpRFA sessions for uninodular HCC (mean size 26 mm). Of these, 76 (33%) developed bile duct changes (upstream bile duct dilatations and/or bilomas) with a mean onset time of 3 months. Identified risk factors for these changes were the infiltrative aspect of the tumor (p = 0.035) and its location in segment VIII (p < 0.01). The average increase in bilirubin at 6 months was higher in the group with biliary changes (+2.9 vs. +0.4 µg/mL; p = 0.03). There were no significant differences in terms of complications, cirrhosis decompensation at 1 year (p = 0.95), local and distant tumor progression (p = 0.91 and 0.14 respectively), and overall survival (p = 0.4) between the two groups.
CONCLUSIONS: Bile duct changes are common after mbpRFA for HCC, especially in tumors with an infiltrative aspect or those located in segment VIII. These changes do not appear to negatively impact the course of cirrhosis at 1 year or overall survival.
CONCLUSIONS: Bile duct changes following mbpRFA for HCC are relatively common. Nevertheless, they do not raise clinical concerns in terms of complications, deterioration in liver function, or survival rates. Consequently, specific monitoring or interventions for these bile duct changes are not warranted.
CONCLUSIONS: • Bile duct changes are frequently observed after multibipolar radiofrequency ablation for hepatocellular carcinoma, occurring in 33% of cases in our study. • Patients with bile duct changes exhibited a higher increase in bilirubin levels at 6 months but no more cirrhosis decompensation or liver abscesses. • Biliary changes following multibipolar radiofrequency ablation for hepatocellular carcinoma are not alarming and do not necessitate any specific monitoring or intervention.
METHODS: Radiological, clinical, and biological data from consecutive cirrhotic patients who underwent first-line mbpRFA between 2007 and 2014 for uninodular HCC ≤ 5 cm were retrospectively collected. Follow-up imaging was reviewed to identify bile duct changes and factors associated with biliary changes were assessed using multivariable analysis. Baseline and 6-month liver function tests were compared in patients with and without bile duct changes. Complications, cirrhosis decompensation, and survival rates were compared in both groups.
RESULTS: A total of 231 patients (mean age 68 years [39-85], 187 men) underwent 266 mbpRFA sessions for uninodular HCC (mean size 26 mm). Of these, 76 (33%) developed bile duct changes (upstream bile duct dilatations and/or bilomas) with a mean onset time of 3 months. Identified risk factors for these changes were the infiltrative aspect of the tumor (p = 0.035) and its location in segment VIII (p < 0.01). The average increase in bilirubin at 6 months was higher in the group with biliary changes (+2.9 vs. +0.4 µg/mL; p = 0.03). There were no significant differences in terms of complications, cirrhosis decompensation at 1 year (p = 0.95), local and distant tumor progression (p = 0.91 and 0.14 respectively), and overall survival (p = 0.4) between the two groups.
CONCLUSIONS: Bile duct changes are common after mbpRFA for HCC, especially in tumors with an infiltrative aspect or those located in segment VIII. These changes do not appear to negatively impact the course of cirrhosis at 1 year or overall survival.
CONCLUSIONS: Bile duct changes following mbpRFA for HCC are relatively common. Nevertheless, they do not raise clinical concerns in terms of complications, deterioration in liver function, or survival rates. Consequently, specific monitoring or interventions for these bile duct changes are not warranted.
CONCLUSIONS: • Bile duct changes are frequently observed after multibipolar radiofrequency ablation for hepatocellular carcinoma, occurring in 33% of cases in our study. • Patients with bile duct changes exhibited a higher increase in bilirubin levels at 6 months but no more cirrhosis decompensation or liver abscesses. • Biliary changes following multibipolar radiofrequency ablation for hepatocellular carcinoma are not alarming and do not necessitate any specific monitoring or intervention.
摘要：
目的：本研究旨在评估肝细胞癌（HCC）多双极射频消融（mbpRFA）后胆管变化的发生率和临床意义。
方法：放射学，临床,回顾性收集了2007年至2014年期间接受一线mbpRFA治疗≤5cm单结节性HCC的连续肝硬化患者的生物学数据.随访影像学检查以确定胆管变化，并使用多变量分析评估与胆管变化相关的因素。比较有和没有胆管变化的患者的基线和6个月肝功能测试。并发症,肝硬化代偿失调,比较两组的生存率。
结果：总共231名患者（平均年龄68岁[39-85]，187名男性)接受了266mbpRFA治疗单结节HCC(平均大小26毫米)。其中,76例（33％）发生胆管变化（上游胆管扩张和/或胆汁瘤），平均发病时间为3个月。确定的这些变化的危险因素是肿瘤的浸润方面（p=0.035）及其在VIII段的位置（p<0.01）。胆道变化组6个月时胆红素平均升高较高（+2.9vs.+0.4µg/mL；p=0.03）。在并发症方面没有显著差异,1年肝硬化代偿失调（p=0.95），局部和远处肿瘤进展（分别为p=0.91和0.14），两组总生存期(p=0.4)。
结论：对于HCC，mbpRFA后胆管改变很常见，尤其是在具有浸润性方面的肿瘤或位于VIII段的肿瘤中。这些变化似乎不会对肝硬化1年的病程或总生存期产生负面影响。
结论：肝癌患者mbpRFA后胆管变化相对常见。然而，他们不会在并发症方面引起临床关注，肝功能恶化，或存活率。因此,不需要对这些胆管变化进行具体监测或干预.
结论：•肝细胞癌多双极射频消融术后经常观察到胆管变化，在我们的研究中，33%的病例发生。•胆管变化的患者在6个月时表现出更高的胆红素水平增加，但没有更多的肝硬化代偿失调或肝脓肿。•肝细胞癌的多双极射频消融后的胆道变化并不令人担忧，不需要任何特定的监测或干预。
方法：放射学，临床,回顾性收集了2007年至2014年期间接受一线mbpRFA治疗≤5cm单结节性HCC的连续肝硬化患者的生物学数据.随访影像学检查以确定胆管变化，并使用多变量分析评估与胆管变化相关的因素。比较有和没有胆管变化的患者的基线和6个月肝功能测试。并发症,肝硬化代偿失调,比较两组的生存率。
结果：总共231名患者（平均年龄68岁[39-85]，187名男性)接受了266mbpRFA治疗单结节HCC(平均大小26毫米)。其中,76例（33％）发生胆管变化（上游胆管扩张和/或胆汁瘤），平均发病时间为3个月。确定的这些变化的危险因素是肿瘤的浸润方面（p=0.035）及其在VIII段的位置（p<0.01）。胆道变化组6个月时胆红素平均升高较高（+2.9vs.+0.4µg/mL；p=0.03）。在并发症方面没有显著差异,1年肝硬化代偿失调（p=0.95），局部和远处肿瘤进展（分别为p=0.91和0.14），两组总生存期(p=0.4)。
结论：对于HCC，mbpRFA后胆管改变很常见，尤其是在具有浸润性方面的肿瘤或位于VIII段的肿瘤中。这些变化似乎不会对肝硬化1年的病程或总生存期产生负面影响。
结论：肝癌患者mbpRFA后胆管变化相对常见。然而，他们不会在并发症方面引起临床关注，肝功能恶化，或存活率。因此,不需要对这些胆管变化进行具体监测或干预.
结论：•肝细胞癌多双极射频消融术后经常观察到胆管变化，在我们的研究中，33%的病例发生。•胆管变化的患者在6个月时表现出更高的胆红素水平增加，但没有更多的肝硬化代偿失调或肝脓肿。•肝细胞癌的多双极射频消融后的胆道变化并不令人担忧，不需要任何特定的监测或干预。
