Levit Elena, Bruners Philipp, Günther Rolf W, Mahnken Andreas H
Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Aachen, Germany.
Acta Radiol. 2012 Nov 1;53(9):1045-8. doi: 10.1258/ar.2012.120190. Epub 2012 Aug 1.
Radiofrequency ablation (RFA) of liver tumors is a mainstay of interventional oncology. Its application, however, is limited by tumor size and location with lesions located within 1 cm to the gallbladder being at increased risk for complications.
To evaluate the safety of hepatic RFA after bile aspiration with or without additional hydrodissection for lesions adjacent to the gallbladder.
Six patients undergoing RFA of tumors with a distance of less than 1 cm to the gallbladder were retrospectively identified from a computer database. All patients underwent RFA combined with percutaneous bile aspiration from the gallbladder. In four patients additional hydrodissection was performed. Technical success and post-interventional complications were assessed by reviewing images and patient charts.
Ablations were successfully completed in 5/6 patients. In one patient with incomplete ablation re-ablation was performed 2 months after the initial procedure. Minor complications occurred in three patients, including right-sided pleural effusion, hematoma in the gallbladder fossa, and intralesional hemorrhage in one patient each. There were no cases with cholecystitis or damage to the gallbladder during follow-up.
Bile aspiration with or without additional hydrodissection permits safe RFA of tumors located close to the gallbladder.
肝脏肿瘤的射频消融术（RFA）是介入肿瘤学的主要手段。然而，其应用受到肿瘤大小和位置的限制，距离胆囊1厘米以内的病变发生并发症的风险增加。
评估对胆囊附近病变进行胆汁抽吸联合或不联合额外的水分离术之后进行肝脏射频消融术的安全性。
从计算机数据库中回顾性地确定6例接受距离胆囊小于1厘米的肿瘤射频消融术的患者。所有患者均接受射频消融术并经皮从胆囊抽吸胆汁。4例患者进行了额外的水分离术。通过回顾图像和患者病历评估技术成功率和介入后并发症。
6例患者中有5例成功完成消融。1例消融不完全的患者在初次手术后2个月进行了再次消融。3例患者出现轻微并发症，包括右侧胸腔积液、胆囊窝血肿和1例患者的病灶内出血。随访期间无胆囊炎或胆囊损伤病例。
胆汁抽吸联合或不联合额外的水分离术可安全地对靠近胆囊的肿瘤进行射频消融术。
