Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지
DOI QR코드

DOI QR Code

Bile Duct Patency Maintained after Intraductal Radiofrequency Ablation in a Case of Hepatocellular Cholangiocarcinoma with Bile Duct Invasion

  • Han, Sung Yong (Department of Internal Medicine, Pusan National University Hospital, Biomedical Research Institute, and Pusan National University School of Medicine) ;
  • Song, Geun Am (Department of Internal Medicine, Pusan National University Hospital, Biomedical Research Institute, and Pusan National University School of Medicine) ;
  • Kim, Dong Uk (Department of Internal Medicine, Pusan National University Hospital, Biomedical Research Institute, and Pusan National University School of Medicine) ;
  • Baek, Dong Hoon (Department of Internal Medicine, Pusan National University Hospital, Biomedical Research Institute, and Pusan National University School of Medicine) ;
  • Lee, Moon Won (Department of Internal Medicine, Pusan National University Hospital, Biomedical Research Institute, and Pusan National University School of Medicine) ;
  • Kim, Gwang Ha (Department of Internal Medicine, Pusan National University Hospital, Biomedical Research Institute, and Pusan National University School of Medicine)
  • Received : 2017.06.12
  • Accepted : 2017.07.02
  • Published : 2018.03.30
⟨ Previous Next ⟩

Abstract

Combined hepatocellular-cholangiocarcinoma (HCC-CC) with bile duct invasion (BDI) is rare. In unresectable cases, biliary stent placement and photodynamic therapy (PDT) are used for resolving obstructive jaundice. However, stent occlusion remains problematic, and PDT is expensive and time-consuming. Intraductal radiofrequency ablation (RFA) is an emerging procedure for palliation in these patients. It has potential benefits including less expense, lower rates of severe complication, longer maintenance of ductal patency, and easier technique compared with PDT or stenting alone. We report a 67-year-old man who underwent repeated intraductal RFA for HCC-CC and HCC with BDI, for whom bile duct patency was maintained without additional biliary procedures.

Keywords

Acknowledgement

Supported by : Pusan National University

References

  1. Garancini M, Goffredo P, Pagni F, et al. Combined hepatocellular-cholangiocarcinoma: a population-level analysis of an uncommon primary liver tumor. Liver Transpl 2014;20:952-959. https://doi.org/10.1002/lt.23897
  2. Meng KW, Dong M, Zhang WG, Huang QX. Clinical characteristics and surgical prognosis of hepatocellular carcinoma with bile duct invasion. Gastroenterol Res Pract 2014;2014:604971.
  3. Yu XH, Xu LB, Liu C, Zhang R, Wang J. Clinicopathological characteristics of 20 cases of hepatocellular carcinoma with bile duct tumor thrombi. Dig Dis Sci 2011;56:252-259. https://doi.org/10.1007/s10620-010-1256-8
  4. Qin LX, Tang ZY. Hepatocellular carcinoma with obstructive jaundice: diagnosis, treatment and prognosis. World J Gastroenterol 2003;9:385-391. https://doi.org/10.3748/wjg.v9.i3.385
  5. Rustagi T, Jamidar PA. Intraductal radiofrequency ablation for management of malignant biliary obstruction. Dig Dis Sci 2014;59:2635-2641. https://doi.org/10.1007/s10620-014-3237-9
  6. Steel AW, Postgate AJ, Khorsandi S, et al. Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction. Gastrointest Endosc 2011;73:149-153. https://doi.org/10.1016/j.gie.2010.09.031
  7. Dolak W, Schreiber F, Schwaighofer H, et al. Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications. Surg Endosc 2014;28:854-860. https://doi.org/10.1007/s00464-013-3232-9
  8. Chi M, Mikhitarian K, Shi C, Goff LW. Management of combined hepatocellular-cholangiocarcinoma: a case report and literature review. Gastrointest Cancer Res 2012;5:199-202.
  9. Fujii H, Zhu XG, Matsumoto T, et al. Genetic classification of combined hepatocellular-cholangiocarcinoma. Hum Pathol 2000;31:1011-1017. https://doi.org/10.1053/hupa.2000.9782
  10. Wang J, Wang F, Kessinger A. Outcome of combined hepatocellular and cholangiocarcinoma of the liver. J Oncol 2010;2010.
  11. Kassahun WT, Hauss J. Management of combined hepatocellular and cholangiocarcinoma. Int J Clin Pract 2008;62:1271-1278. https://doi.org/10.1111/j.1742-1241.2007.01694.x
  12. Ortner ME, Caca K, Berr F, et al. Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study. Gastroenterology 2003;125:1355-1363. https://doi.org/10.1016/j.gastro.2003.07.015
  13. Zoepf T, Jakobs R, Arnold JC, Apel D, Riemann JF. Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy. Am J Gastroenterol 2005;100:2426-2430. https://doi.org/10.1111/j.1572-0241.2005.00318.x
  14. Pereira SP, Aithal GP, Ragunath K, Devlin J, Owen F, Meadows H. Safety and long term efficacy of porfimer sodium photodynamic therapy in locally advanced biliary tract carcinoma. Photodiagnosis Photodyn Ther 2012;9:287-292. https://doi.org/10.1016/j.pdpdt.2012.03.005
  15. Tal AO, Vermehren J, Friedrich-Rust M, et al. Intraductal endoscopic radiofrequency ablation for the treatment of hilar non-resectable malignant bile duct obstruction. World J Gastrointest Endosc 2014;6:13-19. https://doi.org/10.4253/wjge.v6.i1.13
  16. Cho JH, Lee KH, Kim JM, Kim YS, Lee DH, Jeong S. Safety and effectiveness of endobiliary radiofrequency ablation according to the different power and target temperature in a swine model. J Gastroenterol Hepatol 2017;32:521-526. https://doi.org/10.1111/jgh.13472
  17. Kunzli BM, Abitabile P, Maurer CA. Radiofrequency ablation of liver tumors: actual limitations and potential solutions in the future. World J Hepatol 2011;3:8-14. https://doi.org/10.4254/wjh.v3.i1.8