Biliary complications after percutaneous ablation for patients with hepatic malignant tumors: retrospective analysis of ultrasonic imaging features and clinical outcomes

Abstract

Objective To retrospectively analyze the ultrasonic imaging features and clinical outcomes of biliary complications after percutaneous ablation for hepatic malignant tumors. Methods The cli-nical data of patients with postablation biliary complications who underwent percutaneous ablation for hepatic malignant tumors in the past 7 years in our department were retrospectively analyzed. The ultrasonic imaging features and the clinical outcomes of biliary complications on follow-up of these patients were analyzed. Results Postablation biliary complications occurred in 65 patients, including 34 patients with bile duct dilatation and 31 patients with biloma. In patients with bile duct dilatation, the dilated bile ducts were located distal to the ablation lesions in all these patients. Among 30 patients with bile duct dilatation, the dilatation was progressive in 9 patients (9/30, 30.0%) and stable in 20 patients (20/30, 66.7%), while in one patient (1/30, 3.3%) it resolved on follow-up. The radiologic features of bilomas mainly manifested as four types: crescent, interspersed, circumferential and solitary nodular, and the number of patients with the four types were 13 (13/31, 41.9%), 13(13/31, 41.9%), 3(3/31, 9.7%) and 2(2/31, 6.5%), respectively. In 6 patients (6/31, 19.4%) the bilomas were subjected to interventional or surgical therapy while for the remaining 25 patients (6/31, 19.4%) they were treated conservatively. Three (3/25, 12.0%) of the latter 25 patients had spontaneously disappearance of the biloma and 2 (2/25, 8.0%) of the remaining 22 patients appeared to have progressive increase in size. In 17 (17/25, 68.0%) patients the biloma remained stable in size and in the remaining 3 patients (3/25, 12.0%) the bilomas resolved. Conclusions Postablation biliary complications of ultrasound-guided percutaneous ablation for hepatic malignant tumors mainly presented as biloma and bile duct dilatation. Dilated bile ducts were located in the distal side of the ablation zones. Crescent type and interspersed type were the most common morphological types of biloma. Although most patients with postablation biliary complications of ultrasound-guided percutaneous ablation remained stable or resolved on follow-up, interventional or surgical therapy was necessary in the minority of patients. Key words: Hepatic malignant tumors; Percutaneous ablation; Biliary complication