Complications and clinical outcomes of microwave ablation for liver metastatic cholangiocarcinoma after bilioenteric anastomosis

Abstract

To explore the complications and clinical outcome of liver metastatic cholangiocarcinoma after microwave ablation (MWA) in patients with a history of pancreatoduodenectomy or liver resection with bilioenteric anastomosis. Retrospective study was made on 10 lesions of intra-hepatic metastatic cholangiocarcinoma undergoing MWA (range: 1.5 - 3.6 cm, mean: 3.3 ± 1.3 cm) in 6 patients (5 males and 1 female) from February 2008 to October 2011. All had a history of surgical resection for primary neoplasm and bilioenteric anastomosis. Four cases had intrahepatic biliary dilatation pneumatosis. All lesions were completely ablated according to the results of contrast-enhanced ultrasound (CEUS) or contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) at Month 1 post-MWA. Liver abscess and fistula occurred in 5 ablation zones (5/10) of 4 patients. Three cases were satisfactorily cured with antibiotic dosing, catheter drainage and supportive care. One case died 13 days after MWA. The overall 1, 2, 3-year survival rates of were 64.8%, 21.6% and 21.0% respectively (median: 15.7 months). A high technical success rate of MWA is obtained in the treatment of intrahepatic metastatic cholangiocarcinoma with bilioenteric anastomosis. However, the incidence of abscess formation remains high due to a coexistence of multiple risk factors.