{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:20:11Z","timestamp":1760059211977,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012542","name":"Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation","doi-asserted-by":"publisher","award":["DTCRD111(2)-I-08","MOST 110-2314-B-303-019"],"award-info":[{"award-number":["DTCRD111(2)-I-08","MOST 110-2314-B-303-019"]}],"id":[{"id":"10.13039\/501100012542","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health and Welfare","award":["DTCRD111(2)-I-08","MOST 110-2314-B-303-019"],"award-info":[{"award-number":["DTCRD111(2)-I-08","MOST 110-2314-B-303-019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Thermal ablation of centrally located liver tumors carries an increased risk of bile duct injury due to their proximity to the biliary tree. We aim to evaluate whether biliary cooling using a nasobiliary tube can effectively mitigate bile duct injury during the ablation process. Methods: We retrospectively analyzed the data of 322 patients who underwent thermal ablation at Dalin Tzu Chi Hospital from July 2020 to June 2023 and identified those who received prophylactic biliary cooling during thermal ablation for central liver tumors. Data including demographics, tumor characteristics, procedural details, and clinical outcomes were analyzed. Results: Among the 322 patients who underwent thermal ablation, 9 with central liver tumors received prophylactic biliary cooling. The median distance between the tumor and the central bile duct was 1 mm (range: 0\u20134 mm), the temperature of the cold normal saline was 4 \u00b0C, and the mean volume of normal saline infused was 150 mL (range: 100\u2013200 mL). Complete ablation was achieved in all patients in a single session without any biliary injury. One patient developed acute cholangitis after ENBD placement, which resolved with antibiotic therapy. Conclusions: Biliary cooling with 4 \u00b0C cold saline through a nasobiliary tube can improve the safety and effectiveness of thermal ablation for central liver tumors.<\/jats:p>","DOI":"10.3390\/cancers17111859","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T05:09:12Z","timestamp":1748840952000},"page":"1859","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Study on Biliary Cooling During Thermal Ablation of Central Liver Tumors in Taiwan"],"prefix":"10.3390","volume":"17","author":[{"given":"Yi-Chun","family":"Chou","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Wei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping-Hung","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsung-Hsing","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsing-Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Chih","family":"Tseng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-0826","authenticated-orcid":false,"given":"Ching-Sheng","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 97004, Taiwan"},{"name":"Center for Digestive Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan"},{"name":"Department of Medical Research, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan"},{"name":"School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e29321","DOI":"10.1097\/MD.0000000000029321","article-title":"Efficacy and safety of microwave ablation and radiofrequency ablation in the treatment of hepatocellular carcinoma: A systematic review and meta-analysis","volume":"101","author":"Dou","year":"2022","journal-title":"Medicine"},{"key":"ref_2","unstructured":"European Association for the Study of the Liver (2025). EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma. J. Hepatol., 82, 315\u2013374."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1097\/HEP.0000000000000466","article-title":"AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma","volume":"78","author":"Singal","year":"2023","journal-title":"Hepatology"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"De Muzio, F., Cutolo, C., Dell\u2019Aversana, F., Grassi, F., Ravo, L., Ferrante, M., Danti, G., Flammia, F., Simonetti, I., and Palumbo, P. (2022). Complications after Thermal Ablation of Hepatocellular Carcinoma and Liver Metastases: Imaging Findings. Diagnostics, 12.","DOI":"10.3390\/diagnostics12051151"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1007\/s10620-016-4312-1","article-title":"Risk Factors for Bile Duct Injury After Percutaneous Thermal Ablation of Malignant Liver Tumors: A Retrospective Case-Control Study","volume":"62","author":"Lin","year":"2017","journal-title":"Dig. Dis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.jamcollsurg.2003.12.026","article-title":"Intraductal cooling of the main bile ducts during radiofrequency ablation prevents biliary stenosis","volume":"198","author":"Elias","year":"2004","journal-title":"J. Am. Coll. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.ejso.2020.09.033","article-title":"Biliary cooling during radiofrequency ablation of liver tumours close to central biliary tree: A systematic review and pooled analysis","volume":"47","author":"Feretis","year":"2021","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e410","DOI":"10.1111\/j.1440-1746.2007.05091.x","article-title":"Intraductal chilled saline perfusion to prevent bile duct injury during percutaneous radiofrequency ablation for hepatocellular carcinoma","volume":"23","author":"Ohnishi","year":"2008","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.2214\/AJR.14.13788","article-title":"Intraductal Cooling via a Nasobiliary Tube During Radiofrequency Ablation of Central Liver Tumors Reduces Biliary Injuries","volume":"204","author":"Felker","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.ejrad.2008.10.021","article-title":"Prevention of biliary complication in radiofrequency ablation for hepatocellular carcinoma-Cooling effect by endoscopic nasobiliary drainage tube","volume":"73","author":"Ogawa","year":"2010","journal-title":"Eur. J. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jamcollsurg.2008.03.028","article-title":"Safety and efficacy of radiofrequency ablation for periductal hepatocellular carcinoma with intraductal cooling of the central bile duct","volume":"207","author":"Lam","year":"2008","journal-title":"J. Am. Coll. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1002\/bjs.5002","article-title":"Experimental bile duct protection by intraductal cooling during radiofrequency ablation","volume":"92","author":"Stippel","year":"2005","journal-title":"Br. J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.2214\/ajr.183.6.01831611","article-title":"Changes in bile ducts after radiofrequency ablation of hepatocellular carcinoma: Frequency and clinical significance","volume":"183","author":"Kim","year":"2004","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/jso.1049","article-title":"Intraductal cooling of the main bile ducts during intraoperative radiofrequency ablation","volume":"76","author":"Dominique","year":"2001","journal-title":"J. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e189","DOI":"10.1097\/SLE.0b013e3181f91ba2","article-title":"Two cases of hepatocellular carcinoma located adjacent to the Glisson\u2019s capsule treated by laparoscopic radiofrequency ablation with intraductal chilled saline perfusion through an endoscopic nasobiliary drainage tube","volume":"20","author":"Nakata","year":"2010","journal-title":"Surg. Laparosc. Endosc. Percutaneous Tech."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e30725","DOI":"10.1097\/MD.0000000000030725","article-title":"Multipolar radiofrequency ablation via three bipolar electrodes with C-arm type X-ray fluoroscopy assistance for hepatocellular carcinoma: An observational study","volume":"101","author":"Tanaka","year":"2022","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.dld.2014.07.012","article-title":"Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation","volume":"46","author":"Facciorusso","year":"2014","journal-title":"Dig. Liver Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/BF02725339","article-title":"Radiofrequency ablation of 231 unresectable hepatic tumors: Indications, limitations, and complications","volume":"7","author":"Wood","year":"2000","journal-title":"Ann. Surg. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1002\/bjs.5059","article-title":"Adverse effects of radiofrequency ablation of liver tumours in the Netherlands","volume":"92","author":"Jansen","year":"2005","journal-title":"Br. J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.2214\/ajr.175.6.1751619","article-title":"Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year","volume":"175","author":"Elias","year":"2000","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jvir.2013.10.012","article-title":"Percutaneous ablation of peribiliary tumors with irreversible electroporation","volume":"25","author":"Silk","year":"2014","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1080\/02656736.2022.2079733","article-title":"Biliary complications and efficacy after ablation of peribiliary tumors using irreversible electroporation (IRE) or radiofrequency ablation (RFA)","volume":"39","author":"Thamtorawat","year":"2022","journal-title":"Int. J. Hyperth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3000605221111281","DOI":"10.1177\/03000605221111281","article-title":"Efficacy of percutaneous ethanol injection versus radiofrequency ablation for single hepatocellular carcinoma no larger than 5\u2009cm","volume":"50","author":"Yang","year":"2022","journal-title":"J. Int. Med. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"101897","DOI":"10.1016\/j.bpg.2024.101897","article-title":"Management of ERCP complications","volume":"69","author":"Pal","year":"2024","journal-title":"Best Pract. Res. Clin. Gastroenterol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/11\/1859\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:44:59Z","timestamp":1760031899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/11\/1859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,31]]},"references-count":24,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["cancers17111859"],"URL":"https:\/\/doi.org\/10.3390\/cancers17111859","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2025,5,31]]}}}