Yu Hong-Bao, Ge Cheng-Lin, Huang Zong-Hai, Wang Hao, Liu Zeng-Yi, Zhang Ji-Ren
Tumor Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2009 Mar;29(3):538-40.
To observe the effect of targeted argon-helium cryoablation on portal region of the liver in dogs by observing the pathological changes in the first-order branches of the Glisson ductal system.
Twelve healthy dogs underwent percutaneous targeted argon-helium cryoablation of the liver and sacrificed at 3 and 28 days after the cryoablation to observe the pathological changes in target area for cryoablation and the first-order branches of the Glisson ductal system.
No obvious damage was not found in the vascular wall of the portal vein by gross or microscopic observation, but the liver tissue in the vicinity of the blood vessels showed total necrosis. In spite of the injuries of different degrees in the first-order bile duct system after argon-helium cryoablation, no severe damages such as perforation or full-thickness necrosis occurred in bile duct wall, and most of the injuries were temporary and reversible. The size of the ablated area on day 28 was significantly reduced as compared with that on day 3 following the cryoablation (P<0.05). In the acute stage after the cryoablation (1-3 days), ALT and AST levels increased significantly in (P<0.05) but recovered 1-4 weeks later (P>0.05). The cryoablated area was basically consistent with the pathological area that underwent necrosis (P>0.05).
Targeted argon-helium cryoablation can cause total destruction of the liver tissue around the blood vessel without damaging the vascular walls of the portal vein. Argon-helium cryoablation induces relatively minor injuries to the bile duct of hepatic portal section and does not obviously damage the liver function, and the scope of tissue necrosis can be estimated according to the size of frozen area observed. Argon-helium cryoablation is a safe and minimally invasive operation with reliable therapeutic effect.
通过观察肝门管系统一级分支的病理变化，探讨氩氦靶向冷冻消融术对犬肝脏肝门区的影响。
12只健康犬接受经皮肝氩氦靶向冷冻消融术，分别于冷冻消融术后3天和28天处死，观察冷冻消融靶区及肝门管系统一级分支的病理变化。
大体及镜下观察门静脉血管壁未见明显损伤，但血管周围肝组织呈完全坏死。氩氦冷冻消融术后一级胆管系统虽有不同程度损伤，但胆管壁未出现穿孔、全层坏死等严重损伤，且多数损伤为一过性、可逆性。冷冻消融术后28天消融区面积较术后3天明显缩小（P<0.05）。冷冻消融术后急性期（13天）谷丙转氨酶（ALT）、谷草转氨酶（AST）水平显著升高（P<0.05），14周后恢复（P>0.05）。冷冻消融区与病理坏死区基本一致（P>0.05）。
氩氦靶向冷冻消融术可使血管周围肝组织完全破坏，而不损伤门静脉血管壁。氩氦冷冻消融术对肝门部胆管损伤相对较小，对肝功能无明显损害，可根据观察到的冷冻范围估计组织坏死范围。氩氦冷冻消融术是一种安全、微创、疗效可靠的治疗方法。
