To investigate the application value of radiofrequency ablation (RFA) for primary liver cancer complicated with bile duct tumor thrombus (BDTT).

Clinical data of 14 patients with primary liver cancer and BDTT undergoing RFA in Chinese PLA General Hospital between December 2009 and December 2014 were retrospectively analyzed. There were 11 males and 3 females, aged from 45 to 68 years old with a median age of 54 years old. All patients were complicated with liver cirrhosis. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients first underwent ultrasound-guided RFA through open surgery for the tumor, and then underwent choledochotomy + removal of BDTT, and finally ablation of the root of BDTT. Perioperative status, incidence of postoperative complications and clinical prognosis of the patients were observed.

All patients underwent surgery successfully. The intraoperative blood loss was ≤50 ml and the postoperative length of hospital stay ranged from 8 to 34 d. The incidence of postoperative complications was 71%(10/14), including 10 cases with pleural effusion, 8 with exacerbation of ascites, 6 with elevated bilirubin and 3 with renal dysfunction. All complications were alleviated after liver-protecting and nutrition supportive therapy. No death was observed during the perioperative period. At 1 months after surgery, residual tumor was found in 2 cases and they were treated with transcatheter arterial chemoembolization (TACE). Ten patients died during the follow-up. The survival time ranged from 9 to 22 months with a median of 17 months and the 1-year survival rate 85%.

RFA is a safe, effective and ideal treatment for patients with unresectable primary liver cancer and BDTT, and it can significantly reduce the intraoperative blood loss during BDTT removal.