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

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.

Keywords: CT-guided radiofrequency ablation; Complication; Hemobilia; Hepatocellular carcinoma; Liver tumors.