Zeng Jianying, Qin Zilin, Zhou Liang, Fang Gang, Chen Jibing, Li Jialiang, Niu Lizhi, Liang Bing, Xu Kecheng
School of Medicine, Jinan University, Guangdong Province, Guangzhou, China; Fuda Cancer Hospital, Jinan University School of Medicine, Guangdong Province, Guangzhou, China.
Fuda Cancer Hospital, Jinan University School of Medicine, Guangdong Province, Guangzhou, China.
Radiol Oncol. 2017 Jan 14;51(1):40-46. doi: 10.1515/raon-2017-0003. eCollection 2017 Mar 1.
The ablation of liver tumors located close to the gallbladder is likely to lead to complications. The aim of this article is to compare the safety and efficacy of irreversible electroporation (IRE) and cryoablation in rabbit livers at a location close to the gallbladder.
We performed cryoablation (n = 12) and IRE (n = 12) of the area of the liver close to the gallbladder in 24 New Zealand white rabbits in order to ensure gallbladder damage. Serum aminotransferase and serum bilirubin levels were measured before and after the ablation. Histopathological examination of the ablation zones in the liver and gallbladder was performed on the 7 day after the ablation.
Seven days after the ablation, all 24 animals were alive. Gallbladder perforation did not occur in the IRE group; only mucosal epithelial necrosis and serous layer edema were found in this group. Gallbladder perforation occurred in four rabbits in the cryoablation group. Serum aminotransferase and serum bilirubin levels obviously increased in both groups by Day 3 and decreased gradually thereafter. The elevation in aminotransferase and bilirubin levels was greater in the cryoablation group than the IRE group. Pathological examination revealed complete necrosis of the liver parenchyma from the ablation center to the gallbladder in both groups, but bile duct and granulation tissue hyperplasia were observed in only the IRE group. Full-thickness gallbladder-wall necrosis was seen in the cryoablation group.
For ablation of the liver area near the gallbladder, IRE is superior to cryoablation, both in terms of safety (no gallbladder perforation in the IRE group) and efficacy (complete necrosis and rapid recovery in the IRE group).
靠近胆囊的肝脏肿瘤消融术可能会引发并发症。本文旨在比较不可逆电穿孔（IRE）和冷冻消融术在兔肝脏靠近胆囊部位的安全性和有效性。
为确保胆囊受损，我们对24只新西兰白兔靠近胆囊的肝脏区域进行了冷冻消融术（n = 12）和IRE（n = 12）。在消融术前和术后测量血清转氨酶和血清胆红素水平。在消融术后第7天对肝脏和胆囊的消融区域进行组织病理学检查。
消融术后7天，所有24只动物均存活。IRE组未发生胆囊穿孔；该组仅发现黏膜上皮坏死和浆膜层水肿。冷冻消融组有4只兔子发生胆囊穿孔。两组血清转氨酶和血清胆红素水平在第3天均明显升高，此后逐渐下降。冷冻消融组转氨酶和胆红素水平的升高幅度大于IRE组。病理检查显示两组从消融中心到胆囊的肝实质均完全坏死，但仅IRE组观察到胆管和肉芽组织增生。冷冻消融组可见胆囊壁全层坏死。
对于靠近胆囊的肝脏区域消融，IRE在安全性（IRE组无胆囊穿孔）和有效性（IRE组完全坏死且恢复迅速）方面均优于冷冻消融术。
