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Neuro
Krebs
Kardio
Lipid
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Silk, MT; Wimmer, T; Lee, KS; Srimathveeravalli, G; Brown, KT; Kingham, PT; Fong, Y; Durack, JC; Sofocleous, CT; Solomon, SB.
Percutaneous ablation of peribiliary tumors with irreversible electroporation.
J Vasc Interv Radiol. 2014; 25(1):112-118
Doi: 10.1016/j.jvir.2013.10.012
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
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Wimmer Thomas
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- Abstract:
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To assess biliary complications after irreversible electroporation (IRE) ablation of hepatic tumors located < 1 cm from major bile ducts.
A retrospective review was conducted of all percutaneous IRE ablations of hepatic tumors within 1 cm of the common, left, or right hepatic ducts at a single institution from January 2011 to September 2012. Computed tomography imaging performed before and after treatment was examined for evidence of bile duct dilatation, stricture, or leakage. Serum bilirubin and alkaline phosphatase levels were analyzed for evidence of biliary injury.
There were 22 hepatic metastases in 11 patients with at least one tumor within 1 cm of the common, left, or right hepatic duct that were treated with IRE ablations in 15 sessions. Median tumor size treated was 3.0 cm (mean, 2.8 cm ± 1.2, range, 1.0-4.7 cm). Laboratory values obtained after IRE were considered abnormal after four treatment sessions in three patients (bilirubin, 2.6-17.6 mg/dL; alkaline phosphatase, 130-1,035 U/L); these abnormal values were transient in two sessions. Two patients had prolonged elevation of values, and one required stent placement; both of these conditions appeared to be secondary to tumor progression rather than bile duct injury.
This clinical experience suggests that IRE may be a treatment option for centrally located liver tumors with margins adjacent to major bile ducts where thermal ablation techniques are contraindicated. Further studies with extended follow-up periods are necessary to establish the safety profile of IRE in this setting.
© 2013 The Society of Interventional Radiology Published by SIR All rights reserved.
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Ablation Techniques - adverse effects
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Aged -
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Aged, 80 and over -
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Alkaline Phosphatase - blood
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Bilirubin - blood
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Biomarkers - blood
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Cholestasis - blood
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Cholestasis - diagnostic imaging
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Cholestasis - etiology
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Disease Progression -
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Hepatic Duct, Common - diagnostic imaging
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Hepatic Duct, Common - injuries
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Hepatic Duct, Common - pathology
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Liver Neoplasms - secondary
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Liver Neoplasms - surgery
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Middle Aged -
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Tomography, X-Ray Computed -
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Treatment Outcome -
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