Incidence and risk factors of severe biliary-related complications after radio-frequency ablation for malignant liver tumors

LU Qin; WU Wei; ZHANG Zhongyi; WANG Song; YANG Wei; YAN Kun; CHEN Minhua

doi:10.19300/j.2025.L22065

Abstract：Objective To analyze the incidence and related risk factors of severe biliary complications following percutaneous ultrasound-guided radiofrequency ablation(RFA)for malignant liver tumors.Methods Clinical data,laboratory examination,and imaging findings from 769 patients with malignant liver tumors who underwent percutaneous ultrasound-guided RFA were retrospectively collected.There were a total of 1,212 lesions with an average maximum diameter(1.9±0.8)cm.Based on whether severe biliary complications occurred after RFA,patients were divided into a complication group(9 cases)and a control group(760 cases).Clinical variables,laboratory indicators,pathological tumor types,and imaging featureswere compared between groups using Fisher's exact test or the Mann-Whitney U test.Multivariate Logistic regression analysis was performed to identify independent risk factors for severe biliary complications.Results The incidence of severe biliary complications after RFA was 1.2%(9/769).Compared to the control group,the complication group had a higher proportion of patients with a history of cholecystectomy or choledochojejunostomy,preoperative albumin(ALB)＜28 g/L,liver metastases from biliary system tumors,and tumors located near critical anatomical sites(all P＜0.05).Multivariate Logistic regression analysis showed that a history of cholecystectomy or choledochojejunostomy(OR=22.563,95%CI:4.320-117.844),preoperative ALB＜28 g/L(OR=175.982,95%CI:20.164-1 535.921),and liver metastases from biliary system tumors(OR=17.437,95%CI:3.143-96.728)were independent risk factors for severe biliary complications after RFA(all P＜0.05).Conclusions Severe biliary complications following RFA for malignant liver tumors are rare and influenced by multiple factors.A history of cholecystectomy or choledochojejunostomy,preoperative ALB＜28 g/L,and liver metastasis from biliary system tumors are independent risk factors for severe biliary complications.