ABSTRACT
Objective To investigate the risk factors of biliary tract complications in patients with liver cancer after thermal ablation and the prevention methods.Methods One thousand seven hundred and ninety-seven patients with liver cancer underwent percutaneous thermal ablation were enrolled in this retrospective study.According to the relative position of the tumor and biliary tract,patients were classified into 4 groups:with the tumor close to the first branch (group Ⅰ),the second branch (group Ⅱ),the third branch of bile duct (group Ⅲ) and far away from the biliary tract (group Ⅳ).The tumor response and complications,especially biliary tract complications after ablation therapy of subgroups were analyzed.Results A total of 2 356 sessions were performed in 1 797 patients with 3 200 lesions.The local progression rates of the tumors close to and far away from biliary were 10.0 ％ and 8.2 ％ (P =0.080) and the rate of complete ablation were 96.5 ％ and 97.2 ％ (P =0.298),respectively.Fourteen patients suffered from major biliary complications after thermal ablation.Biliary complication incidences of the patients with the tumor close to the first,the second biliary tract were 6.5 ％ and 2.9 ％ respectively,which were all higher than those of the patients with the tumor close to the third(0.3％) and far away from biliary duct(0.2％).Conclusions Percutaneous thermal ablation is an efficient and safe method in the treatment of tumors close to biliary tract and with a low incidence of major biliary complications.Patients with a tumor close to the large branch of biliary duct were at high risk of complications.Those tumors,therefore,should be ablated with assisting methods and extra care.
ABSTRACT
Objective To investigate the accuracy and availability of three‐dimensional ultrasonography ( 3DUS ) in the Bismuth‐Corlette classification of hilar cholangiocarcinoma ( HCCA ) . Methods Forty‐eight patients who underwent surgery and obtained pathologic diagnosis of HCCA were retrospectively analyzed . All patients underwent 3DUS and magnetic resonance cholangiopancreatography (MRCP) before surgery . With surgical outcomes as the gold standard ,the diagnostic efficacy of two examinations in classification of HCCA were compared . Results Forty‐eight cases of HCCA were divided into 5 types according to surgical results ,including type Ⅰ (8 cases) ,type Ⅱ(13 cases) ,Ⅲa(8 cases) ,Ⅲb (11 cases) and type Ⅳ(8 cases) respectively . Among them ,39 cases accepted radical resection and the rest of 9 cases received palliative resection . The accuracy of the Bismuth classification confirmed by 3DUS was 85 .4% (41/48) . The percentage of underestimated and overestimated classification confirmed by 3DUS were 10 .4% (5/48) and 4 .2% (2/48) respectively . The accuracy of the classification confirmed by MRCP was 87 .4% (42/48) .Both of the percentage of underestimated and overestimated classification confirmed by MRCP were samely 6 .3% (3/48) .The difference between the 3DUS and MRCP was not statistically significant(χ2 =0 .597 ,P=0 .440) . Both the percentage of underestimated and overestimated classification between 3DUS and MRCP were samely not statistically significant ( P =0 .714 , P =1 .000 ,respectively) . Conclusions As a new diagnostic technique ,3DUS was feasible and had significant value in evaluating HCCA classification comparable to MRCP .