| [Objectives] The bile duct injury by thermal damage in Microwave Ablation for Periductal Hepatocellular Carcinoma may cause severe complications,liver failure and death.This article aims to Compare the outcomes among Intraductal Cooling through Percutaneous Transhepatic Cholangial Drainage Tube and endoscopic nasobiliary drainage tube in Microwave Ablation for Periductal Hepatocellular Carcinoma, and select the better Intraductal Cooling technique to prevent bile duct thermal injury for patients with Periductal Hepatocellular Carcinoma.[Methods] Retrospectively collected clinical data of patients, performed Microwave Ablation for Periductal Hepatocellular Carcinoma by Intraductal Cooling technique in Department of Radioactive Intervention, Eastern Hepatobiliary Surgery Hospital from September 2013 to June 2015. 23 consecutive HCC patients with 23 nodules close to central bile duct were enrolled in this study. We placed 12 PTCD tubes and 11 endoscopic nasobiliary drainage (ENBD) tubes in the hepatic duct close to the lesions, then infused 4℃ chilled saline solution via the PTCD tube or ENBD tube to prevent bile duct injury during MWA.The major outcomes for evaluation were bile duct complications related to MWA and local tumor recurrence.[Results] There were 1 case (8.33%) of bile leakage in PTCD group and 2 cases (18.18%) of biloma in ENBD group. There wasn’t any complication related to PTCD procedure, but 3 cases (27.27%) suffered acute pancreatitis and 1 cases (9.09%) suffered hemorrhage in ENBD group (P= 0.037).1 case (8.33%) and 1 case (9.09%) of local recurrence was observed in PTCD group and ENBD group, respectively.[Conclusions] Intraductal Cooling technique by PTCD tubes technically feasible and effective to prevent bile duct thermal injury caused by MWA of HCC closed to central bile ducts, which may be safer compared to ENBD tube technique. |
PDF Full Text Request