Abstract

Purpose

This study aimed to evaluate the incidence and severity of biliary complications after treating periductal hepatocellular carcinomas (HCCs) using either cryoablation (CA) or radiofrequency ablation (RFA) and assess independent risk factors for biliary complications after treatment.

Materials and methods

Between July 2008 and August 2018, 949 patients with treatment-naïve HCCs underwent either RFA or CA in our institution. Of these, patients with multiple HCCs, tumors equal to or larger than 3 cm or smaller than 1 cm, and tumors with non-periductal locations were excluded. Finally, 31 patients and 25 patients were included in the RFA group and the CA group, respectively. The incidence and severity of biliary complications were compared between the RFA and CA groups. The risk factors for biliary complications were assessed using univariable and multivariable logistic regression analyses using the following variables: age, sex, tumor size, Child–Pugh score, tumor location (peripheral duct versus central duct), ablation method (RFA versus CA), the number of applicators, ablation time, and ablation volume.

Results

The incidence and severity of biliary complications were significantly higher in the RFA group than in the CA group (p = 0.007 and p = 0.002, respectively). In univariable and multivariable analyses, the ablation method was an independent risk factor for biliary complications (p = 0.004 and 0.013, respectively).

Conclusions

The incidence and severity of biliary complications after treating HCCs abutting the bile duct are lower in CA than RFA, demonstrating that CA is safer than RFA for ablating small periductal HCCs.

中文翻译：

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经皮冷冻消融与射频消融治疗导管周围肝细胞癌手术相关并发症的比较

摘要

目的

本研究旨在评估使用冷冻消融 (CA) 或射频消融 (RFA) 治疗导管周围肝细胞癌 (HCC) 后胆道并发症的发生率和严重程度，并评估治疗后胆道并发症的独立危险因素。

材料和方法

2008 年 7 月至 2018 年 8 月期间，949 名初治 HCC 患者在我们的机构接受了 RFA 或 CA。其中，排除了多发 HCC、肿瘤等于或大于 3 cm 或小于 1 cm 以及具有非导管周围位置的肿瘤的患者。最后，RFA组和CA组分别有31例和25例。比较 RFA 和 CA 组胆道并发症的发生率和严重程度。使用单变量和多变量逻辑回归分析评估胆道并发症的危险因素，使用以下变量：年龄、性别、肿瘤大小、Child-Pugh 评分、肿瘤位置（外周导管与中央导管）、消融方法（RFA 与 CA）、涂药器的数量、消融时间和消融体积。

结果

RFA 组胆道并发症的发生率和严重程度显着高于 CA 组（分别为p =  0.007 和p =  0.002）。在单变量和多变量分析中，消融方法是胆道并发症的独立危险因素（分别为p =  0.004 和 0.013）。

结论

CA 治疗邻近胆管的 HCC 后胆道并发症的发生率和严重程度低于 RFA，表明 CA 在消融小导管周围 HCC 方面比 RFA 更安全。