Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.
Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK.
Cardiovasc Intervent Radiol. 2019 Jul;42(7):1029-1035. doi: 10.1007/s00270-019-02218-5. Epub 2019 Apr 8.
To report the technique of hydrodissection of the gallbladder bed, in order to separate the gallbladder wall from the liver surface during microwave ablation of liver malignancies located in segment V.
Between January 2018 and March 2018, percutaneous hydrodissection of the gallbladder fossa was performed during four microwave ablation procedures in three patients (One patient was treated twice for the same lesion, making a total of four procedures for three lesions.) All treated lesions were located in segment V and abutting the gallbladder. Number of hydrodissection needles, volume of hydrodissection, repartition of hydrodissection, separation of tumour from the gallbladder post-hydrodissection, technical success of hydrodissection/ablation, and complications were recorded and evaluated.
Hydrodissection of the gallbladder fossa was technically feasible in all four procedures, and microwave ablation was performed at maximum power without any early interruption. Time to perform hydrodissection was 11.3 min on average (range 7-18 min). Minimal distance between the ablation area and the GB increased from virtual to 10 mm on average (range 6-13), with a mean volume of dissection of 65 ml (range 40-100). Technical success was 75%. There was no complication related to the hydrodissection itself, and no acute or delayed gallbladder complication.
Hydrodissection of the gallbladder bed is a feasible technique to separate the gallbladder from the liver surface. This could potentially decrease the risk of thermal injuries to the gallbladder wall when ablating tumours located in segment V.
报告胆囊床水分离技术，以便在微波消融位于 V 段的肝恶性肿瘤时将胆囊壁与肝表面分离。
在 2018 年 1 月至 2018 年 3 月期间，对 3 例患者的 4 次微波消融治疗中进行经皮胆囊窝水分离（1 例患者因同一病灶接受了 2 次治疗，共有 3 个病灶进行了 4 次治疗）。所有治疗的病灶均位于 V 段且毗邻胆囊。记录和评估了水分离针的数量、水分离的体积、水分离的分布、水分离后肿瘤与胆囊的分离、水分离/消融的技术成功率和并发症。
所有 4 例手术均能顺利进行胆囊窝水分离，微波消融均以最大功率进行而无早期中断。水分离的平均时间为 11.3 分钟（范围 7-18 分钟）。消融区与胆囊之间的最小距离从虚拟增加到平均 10 毫米（范围 6-13），平均分离量为 65 毫升（范围 40-100）。技术成功率为 75%。无与水分离本身相关的并发症，也无急性或迟发性胆囊并发症。
胆囊床水分离是一种将胆囊与肝表面分离的可行技术。当消融位于 V 段的肿瘤时，这可能降低胆囊壁热损伤的风险。
