Risk of abscess formation after liver tumor radiofrequency ablation: a review of 8 cases wtih a history of enterobiliary anastomosis.

Abstract

BACKGROUND/AIMS: Rates of postoperative complications after radiofrequency ablation (RFA) remain high for patients who have previously undergone surgery associated with the bile duct. Our purpose is to clarify the rate of postoperative complication and identify preoperative risk factors. METHODOLOGY: This retrospective study reviewed patient backgrounds, ablation areas, and preoperative laboratory data in 8 patients (9 tumors) who underwent RFA after enterobiliary anastomosis. RESULTS: Postoperative complications occurred in 6 of the 8 cases (75%). Postoperative liver abscesses occurred in both the cases of tumor located in the hepatic hilum, i.e., tumor located 5–30 mm from the site of enterobiliary anastomosis. Of the 6 patients with peripherally located tumors, postoperative liver abscesses occurred in 4 patients with elevated preoperative levels of alkaline phosphate (ALP), 3 of whom required abscess drainage. No postoperative complications occurred in the 2 patients with tumors located in the periphery of the liver and with normal preoperative ALP levels. CONCLUSIONS: Postoperative complications are frequent when RFA is performed in patients who have previously undergone enterobiliary anastomosis. These results suggest that RFA after enterobiliary anastomosis should not be recommended. However, the risk may be lower in cases where the nodules are located in the liver periphery and the preoperative ALP level is low.

AI evidence extraction

Main findings

In this retrospective review of 8 patients (9 tumors) with prior enterobiliary anastomosis undergoing liver tumor RFA, postoperative complications occurred in 6/8 cases (75%). Liver abscesses occurred in both cases with tumors in the hepatic hilum (5–30 mm from the anastomosis site) and in 4/6 patients with peripherally located tumors who had elevated preoperative ALP (3 required drainage); no complications occurred in 2 patients with peripheral tumors and normal ALP.

Outcomes measured

• Postoperative complications
• Postoperative liver abscess
• Need for abscess drainage
• Association with tumor location (hepatic hilum vs periphery)
• Association with preoperative alkaline phosphate (ALP) level

Limitations

• Retrospective design
• Very small sample size (8 patients, 9 tumors)
• No control/comparison group described
• Limited detail on patient selection and follow-up in abstract

Suggested hubs

• medical-rf-ablation (0.9)
  Study concerns complications after clinical radiofrequency ablation (RFA) for liver tumors.

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "medical radiofrequency ablation (RFA)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Patients undergoing liver tumor radiofrequency ablation after prior enterobiliary anastomosis",
    "sample_size": 8,
    "outcomes": [
        "Postoperative complications",
        "Postoperative liver abscess",
        "Need for abscess drainage",
        "Association with tumor location (hepatic hilum vs periphery)",
        "Association with preoperative alkaline phosphate (ALP) level"
    ],
    "main_findings": "In this retrospective review of 8 patients (9 tumors) with prior enterobiliary anastomosis undergoing liver tumor RFA, postoperative complications occurred in 6/8 cases (75%). Liver abscesses occurred in both cases with tumors in the hepatic hilum (5–30 mm from the anastomosis site) and in 4/6 patients with peripherally located tumors who had elevated preoperative ALP (3 required drainage); no complications occurred in 2 patients with peripheral tumors and normal ALP.",
    "effect_direction": "harm",
    "limitations": [
        "Retrospective design",
        "Very small sample size (8 patients, 9 tumors)",
        "No control/comparison group described",
        "Limited detail on patient selection and follow-up in abstract"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency ablation",
        "liver tumor",
        "postoperative complications",
        "liver abscess",
        "enterobiliary anastomosis",
        "alkaline phosphate",
        "risk factors"
    ],
    "suggested_hubs": [
        {
            "slug": "medical-rf-ablation",
            "weight": 0.90000000000000002220446049250313080847263336181640625,
            "reason": "Study concerns complications after clinical radiofrequency ablation (RFA) for liver tumors."
        }
    ]
}

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