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Hemobilia after CT-guided radiofrequency ablation of liver tumors: frequency, risk factors, and clinical significance

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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the study is to evaluate the frequency, risk factors, and clinical significance of hemobilia after percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) of liver tumors.

Materials and methods

From January 2013 to September 2016, 195 patients received 267 sessions of CT-guided RFA for liver tumors at our institution. The CT images during and immediately after the RFA were retrospectively reviewed. The frequency of hemobilia development and clinical outcome of patients with hemobilia were studied. Risk factors were identified by comparison between the hemobilia and non-hemobilia groups using univariate and multivariate analysis. The clinical courses of patients with hemobilia were also reviewed.

Results

The frequency of CT detected hemobilia after RFA was 8.2% (22/267). The majority of the clinical courses were self-limited. Univariate analysis showed that the tumor numbers (p = 0.015), the central type puncture track (p < 0.001), the length of the puncture track (p = 0.033), and the platelet count (p = 0.026) were significantly associated with the development of hemobilia. Multivariate analysis demonstrated that the central type puncture track (p < 0.024) and the platelet count (p = 0.023) were significant independent risk factors.

Conclusion

Detection of hemobilia on CT images immediately after percutaneous RFA for liver tumors was not rare. Low platelet count and central type puncture track are independent risk factors. In most cases, hemobilia presented as a minor complication with favorable prognosis.

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Authors and Affiliations

  1. Department of Radiology, Changhua Christian Hospital, Changhua City, Taiwan

    Mei-Fang Hsieh, Chia-Bang Chen & Chen-Te Chou

  2. Transplant Medicine and Surgery Research Centre, Changhua Christian Hospital, Changhua City, Taiwan

    Yao-Li Chen

  3. School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan

    Yao-Li Chen & Chen-Te Chou

  4. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming Medical University, Taipei City, Taiwan

    Chen-Te Chou

  5. Department of Molecular Biotechnology, College of Biotechnology and Bioresources, Dayeh University, Changhua City, Taiwan

    Chen-Te Chou

Authors
  1. Mei-Fang Hsieh
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  2. Chia-Bang Chen
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  3. Yao-Li Chen
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  4. Chen-Te Chou
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Corresponding author

Correspondence to Chen-Te Chou.

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Conflict of interest

All author have no conflict of interest.

Ethical approval

The study was approved by the IRB board of Changhua Christian Hospital.

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Hsieh, MF., Chen, CB., Chen, YL. et al. Hemobilia after CT-guided radiofrequency ablation of liver tumors: frequency, risk factors, and clinical significance. Abdom Radiol 44, 337–345 (2019). https://doi.org/10.1007/s00261-018-1693-y

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