Stippel D L, Töx U, Gossmann A, Beckurts K T E, Hölscher A H
Department of Visceral and Vascular Surgery, University of Cologne, Joseph Stelzmann Strasse 9, 50931 Cologne, Germany.
Surg Endosc. 2003 Dec;17(12):1965-70. doi: 10.1007/s00464-002-9273-0. Epub 2003 Oct 28.
Radiofrequency ablation (RFA) of malignant liver lesions is considered a procedure with low morbidity. However, RFA performed close to hilar structures carries the risk of heat-induced biliary tract damage and subsequent septic episodes.
We performed an analysis of complications in 42 patients with 211 liver lesions treated with a combined approach of liver resection and RFA.
One patient died due to postoperative liver failure. There was one case of temporary liver dysfunction, one vena cava thrombosis, and six febrile episodes. Four of the six febrile episodes were related to bile duct injuries. They became evident 3-5 weeks after the procedure. All four patients were treated successfully by the placement of stents within the biliary tract. None of the patients developed a hepatic abscess.
Biliary tract damage is a complication that can occur weeks after RFA. Immediate endoscopic intervention can obviate the occurrence of prolonged septic complications.
恶性肝病灶的射频消融术（RFA）被认为是一种发病率较低的手术。然而，在靠近肝门结构处进行RFA存在热诱导胆道损伤及随后发生脓毒症发作的风险。
我们对42例患有211个肝病灶并接受肝切除与RFA联合治疗的患者的并发症进行了分析。
1例患者因术后肝衰竭死亡。有1例暂时性肝功能障碍、1例腔静脉血栓形成和6次发热发作。6次发热发作中有4次与胆管损伤有关。这些损伤在手术后3至5周变得明显。所有4例患者通过在胆道内放置支架成功治愈。无一例患者发生肝脓肿。
胆道损伤是RFA术后数周可能发生的并发症。立即进行内镜干预可避免长期脓毒症并发症的发生。
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