Percutaneous radiofrequency ablation for the treatment of hypersplenism due to portal hypertension:a clinical study / 介入放射学杂志

ABSTRACT

Objective To evaluate the feasibility, effectiveness and clinical application of B ultrasound/CT-guided percutaneous radiofrequency ablation (RFA) in treating hypersplenism due to portal hypertension. Methods B ultrasound/CT-guided percutaneous radiofrequency ablation was carried out in 28 patients with hypersplenism associated with portal hypertension. Routine blood counts, liver functions and prothrombin time were determined before RFA and 2 days, 2 weeks, one, 3, 6 and 10 months after RFA separately. The results were analyzed and compared. Enhanced CT scanning reexamination was performed immediately after RFA and one week, one, 3 and 10 months after RFA separately. The volume of ablated spleen tissue was calculated with CT post-processing software. Results The mean operation time was (3.8 ± 1.1) hours and the mean ablation time was (2.7 ± 0.8) hours. The ablated volume of the spleen accounted for 20% - 80% of the whole spleen, with a mean of 50.5% ± 10.3%. Two days after RFA, the platelet count decreased to (19.5 ± 12.1) × 109/L, while the white blood cell count reached its peak value of (5.4+0.2) × 109. From two weeks to 10 months after RFA the white blood cell counts and platelet counts, the liver function, and the prothrombin time were significantly improved when compared with preoperative ones, and the differences were statistically significant (P < 0.05). Pathologically, hepatic proliferation could be seen within the cirrhotic liver after RFA. Child-Pugh score was grade A in all patients except one patient with Child-Pugh grade C who developed abdominal distention and bloody ascites after RFA. No other severe complications occurred. Conclusion For hypersplenism due to portal hypertension, B ultrasound/CT-guided percutaneous radiofrequency ablation is a safe, effective and minimally - invasive treatment.