Background:Thermal ablation of centrally located liver tumors carries an increased risk of bile duct injury due to their proximity to the biliary tree. We aim to evaluate whether biliary cooling using a nasobiliary tube can effectively mitigate bile duct injury during the ablation process.Methods:We retrospectively analyzed the data of 322 patients who underwent thermal ablation at Dalin Tzu Chi Hospital from July 2020 to June 2023 and identified those who received prophylactic biliary cooling during thermal ablation for central liver tumors. Data including demographics, tumor characteristics, procedural details, and clinical outcomes were analyzed.Results:Among the 322 patients who underwent thermal ablation, 9 with central liver tumors received prophylactic biliary cooling. The median distance between the tumor and the central bile duct was 1 mm (range: 0–4 mm), the temperature of the cold normal saline was 4 °C, and the mean volume of normal saline infused was 150 mL (range: 100–200 mL). Complete ablation was achieved in all patients in a single session without any biliary injury. One patient developed acute cholangitis after ENBD placement, which resolved with antibiotic therapy.Conclusions:Biliary cooling with 4 °C cold saline through a nasobiliary tube can improve the safety and effectiveness of thermal ablation for central liver tumors.
背景：位于肝脏中心区域的肿瘤因邻近胆管系统，其热消融治疗存在较高的胆管损伤风险。本研究旨在评估经鼻胆管进行胆道冷却能否有效减轻消融过程中的胆管损伤。 方法：回顾性分析2020年7月至2023年6月期间在大林慈济医院接受热消融治疗的322例患者资料，筛选出其中因中央型肝肿瘤在消融术中接受预防性胆道冷却的病例。对人口统计学特征、肿瘤特性、手术细节及临床结局等数据进行分析。 结果：在322例接受热消融治疗的患者中，9例中央型肝肿瘤患者接受了预防性胆道冷却。肿瘤与中央胆管的中位距离为1毫米（范围：0-4毫米），冷却用生理盐水温度为4°C，平均灌注量为150毫升（范围：100-200毫升）。所有患者均单次实现完全消融，且未发生胆管损伤。1例患者在经鼻胆管引流术后出现急性胆管炎，经抗生素治疗后痊愈。 结论：通过鼻胆管灌注4°C冷生理盐水进行胆道冷却，可提高中央型肝肿瘤热消融治疗的安全性与有效性。
A Retrospective Study on Biliary Cooling During Thermal Ablation of Central Liver Tumors in Taiwan
肿瘤(癌症)患者之家