关键词: 经皮肝胆管穿刺引流术, 经内镜鼻胆管引流术, 肝癌, 微波消融, 胆管热损伤

Abstract: Objective To study on the preventive value of coolant perfusion via catheter systems of percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD) on bile duct thermal injury induced by microwave ablation for hepatocellular carcinoma. Methods Ninety-two patients with hepatocellular carcinoma in portal area underwent microwave ablation were randomly divided into two groups, with 46 cases in each group. The observation group was perfused with PTCD catheter, while the control group was perfused with ENBD catheter for microwave ablation of HCC. The cooling effects of operation and the incidences of complications during follow-up period of time in patients of these two groups were analyzed. Results The time of microwave ablation in the observation group was significantly longer than that in the control group (P<0.05). The incidence of complications in the observation group was 17.39%, which was significantly lower than 43.48% in the control group (P<0.05). The in-situ recurrence rate, intrahepatic recurrence rate, mortality rate and 3-year cumulative survival rate were 8.69%, 41.30%, 32.61%, 67.39% in the observation group, and 8.69%, 36.96%, 28.26%, 71.74% in the control group, respectively, without significant differences between these two groups (P>0.05). Conclusion Both coolant perfusion via PTCD and ENBD catheter systems can prevent bile duct thermal injury induced by microwave ablation for hepatocellular carcinoma in portal area, but coolant perfusion via PTCD catheter is better in safety.

Key words: Percutaneous transhepatic cholangial drainage, Endoscopic nasobiliary drainage, Hepatocellular carcinoma, Microwave ablation, Biliary duct thermal injury