Biliary complications and efficacy after ablation of peribiliary tumors using irreversible electroporation (IRE) or radiofrequency ablation (RFA)
Issued Date
2022-01-01
Resource Type
ISSN
02656736
eISSN
14645157
Scopus ID
2-s2.0-85131271333
Pubmed ID
35649727
Journal Title
International Journal of Hyperthermia
Volume
39
Issue
1
Start Page
751
End Page
757
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Hyperthermia Vol.39 No.1 (2022) , 751-757
Suggested Citation
Thamtorawat S., Patanawanitkul R., Rojwatcharapibarn S., Chaiyasoot W., Tongdee T., Yodying J., Sorotpinya S. Biliary complications and efficacy after ablation of peribiliary tumors using irreversible electroporation (IRE) or radiofrequency ablation (RFA). International Journal of Hyperthermia Vol.39 No.1 (2022) , 751-757. 757. doi:10.1080/02656736.2022.2079733 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/83905
Title
Biliary complications and efficacy after ablation of peribiliary tumors using irreversible electroporation (IRE) or radiofrequency ablation (RFA)
Author's Affiliation
Other Contributor(s)
Abstract
Objective: To evaluate the biliary complication rates and efficacy of peribiliary tumor ablation using irreversible electroporation (IRE) or radiofrequency ablation (RFA). Material and methods: This is a retrospective study of 42 consecutive patients with 44 peribiliary tumors (≤5 mm distance between the tumor margin and the primary or secondary bile duct). Data were collected between January 2014 and September 2020 from patients who underwent percutaneous liver ablation using IRE (n = 13) or RFA (n = 31). Results: The median length of follow-up was 23.1 months. The mean tumor size was 17.2 ± 5.2 mm in IRE vs. 18.4 ± 7.0 mm in RFA (p=.56). Complete tumor ablation was achieved in 100% with a significantly larger ablation zone in the IRE group (3.8 ± 0.3 cm vs. 2.6 ± 0.6 cm, p<.001). Significant biliary complications occurred in one patient (7.7%) of the IRE group and in five patients (16.1%) of the RFA group. Significant risk factors for biliary complications included the RFA procedure (HR 9.71, p=.032) and proximity of the tumor to the bile duct (HR 0.63, p=.048). The local tumor progression (LTP) rates were 7.7% (IRE) vs. 21.5% (RFA) at 1 year, 23.1% (IRE) vs. 32.7% (RFA) at 2 years and 23.1% (IRE) vs. 44% (RFA) at 3 years, respectively (p=.289). Conclusions: The IRE and RFA procedures are safe and effective to treat peribiliary liver tumors. However, the RFA may have a higher risk of significant bile duct injury than IRE. The shorter distance between the bile duct and the tumor is a strong risk factor for biliary complications.