“One-off-Complete Radiofrequency Ablation of Hepatocellular Carcinoma Adjacent to the Gallbladder by a Novel Laparoscopic Technique Without Gallbladder Isolation

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• 作者：Kai Jiang (1)
  Ming Su (1)
  Xiangqian Zhao (1)
  Yongwei Chen (1)
  Wenzhi Zhang (1)
  Jing Wang (1)
  Jiahong Dong (1)
  Zhiqiang Huang (1)
  
• 关键词：Hepatocellular carcinoma ; Radiofrequency ablation ; One ; off ; Special location ; Integrity ; Continuity
• 刊名：Cell Biochemistry and Biophysics
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：68
• 期：3
• 页码：547-554
• 全文大小：1,172 KB
• 参考文献：1. Ansari, D., & Andersson, R. (2012). Radiofrequency ablation or percutaneous ethanol injection for the treatment of liver tumors. / World Journal of Gastroenterology, / 18, 1003-008. CrossRef
  2. Levit, E., Bruners, P., Günther, R. W., & Mahnken, A. H. (2012). Bile aspiration and hydrodissection to prevent complications in hepatic RFA close to the gallbladder. / Acta Radiologica, / 53, 1045-048. CrossRef
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  6. Yamamoto, T., Kubo, S., Hirohashi, K., Tanaka, S., Uenishi, T., Ogawa, M., et al. (2003). Secondary hemocholecyst after radiofrequency ablation therapy for hepatocellular carcinoma. / Journal of Gastroenterology, / 38, 399-03. CrossRef
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  8. Hildebrand, P., Kleemann, M., Roblick, U., Mirow, L., Birth, M., & Bruch, H. P. (2007). Laparoscopic radiofrequency ablation of unresectable hepatic malignancies: Indication, limitation and results. / Hepato-Gastroenterology, / 54, 2069-072.
  9. Laurence, J. M., Tran, P. D., Richardson, A. J., et al. (2012). Laparoscopic or open cholecystectomy in cirrhosis: A systematic review of outcomes and meta-analysis of randomized trials[J]. / The official journal of the International Hepato Pancreato Biliary Association(Oxford), / 14, 153-61. CrossRef
  10. Kai, J., Ming, S., Yang, L., Wen-zhi, Z., Xiang-qian, Z., Zhe L., et al. (2013). Complete radio frequency ablation of hepatocellular carcinoma adjacent to the main bile duct and blood vessels between the first and the second hepatic portal. / Cell Biochemistry Biophysics, / 66(2), 397-02. CrossRef
  
• 作者单位：Kai Jiang (1)
  Ming Su (1)
  Xiangqian Zhao (1)
  Yongwei Chen (1)
  Wenzhi Zhang (1)
  Jing Wang (1)
  Jiahong Dong (1)
  Zhiqiang Huang (1)
  
  1. Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Institute & Hospital of Hepatobiliary Surgery, Chinese PLA Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
  
• ISSN：1559-0283

文摘

The main objective of this study is to assess the feasibility and safety of treating hepatocellular carcinoma (HCC) proximal to the gallbladder using laparoscopic radiofrequency ablation (RFA). Surgical ablation of tumor located adjacent to the gallbladder may damage the gallbladder wall, even with a laparoscope and this ablation method is not precise and incomplete and is frequently combined with alcohol injections with need for further RFA treatment. Four patients were included in this study, with typical HCC where the tumor was present on the left, right, or bed side surrounding the gallbladder. The gallbladder was not separated or removed during larascopic inspection. In the RFA treatment procedure, the tumor lesion was pre-heated for 10?min, and heating was continued for 20?min. The integrity of the gallbladder wall was properly maintained. A follow-up to check for possible local recurrence was carried out 1?year after the RFA. The goal of “one-off-tumor complete RFA is to achieve thorough ablation of the tumor in a single treatment and limiting the possibility of recurrence within 6?months. Seven days after RFA, liver functions of all the patients returned to near-preoperative levels. The patients experienced slight pain in the upper right abdomen, which disappeared in 2-?days. Results of B ultrasound on days 3- showed thickening of the periphery of the ablation area, without significant effusion. Enhanced CT on day 3 showed that RFA low-density area completely covered the lesions. No significant abnormality was observed in the gallbladder and its vicinity. One month after the surgery, B ultrasound and CT examination revealed no significant abnormalities. All patients had an intact gallbladder, and no extrahepatic or intrahepatic bile duct dilatation occurred. There was no evidence of damage to the bile duct or the vessels. Follow-up for 18-2?months found that all patients were in good condition. “One-off-complete RFA can be safely implemented to ablate HCC close to the gallbladder with the assistance of a laparoscope while maintaining integrity and continuity of the gallbladder, and without the need for secondary treatments.