Laparoscopic radiofrequency ablation for hepatic cavernous hemangioma in patients with liver cirrhosis / 中国微创外科杂志

ABSTRACT

Objective To evaluate the feasibility,safety,and efficacy of laparoscopic radiofrequency ablation(RFA) for the treatment of hepatic cavernous hemangioma(HCH) in patients with liver cirrhosis.Methods A total of 15 patients with HCH and liver cirrhosis received laparoscopic RFA under general anesthesia between March 2001 and August 2005.There were 6 men and 9 women,with a mean age of 46.2?7.0 years.All the patients had complained of obvious symptoms of abdominal discomfort,pain,or fullness. The etiologic factor of liver cirrhosis was hepatitis B in 13 patients and hepatitis C in 2 patients.The Child classification revealed grade A in 10 patients and grade B in 5 patients.A total of 20 liver lesions located on the surface of the liver or adjacent to the gallbladder,with a mean diameter of 7.2?1.4 cm,were identified preoperatively in the 15 patients by ultrasonography,helical CT scans,or MRI.The platelet count was(31.2?10.4)?10~9/L.Co-morbidities included chronic calculous cholecystitis in 3 patients and diabetes mellitus in 2 patients.Laparoscopic ultrasonography and liver biopsy were routinely performed during the operation.Results Laparoscopic RFA was successfully performed in all the 15 patients and laparoscopic cholecystectomy was conducted simultaneously in 3 patients.The ablation time per lesion was 68.8?34.0 min,and the total operative time was 120.0?28.0 min.No severe complications,such as intraperitoneal hemorrhage,gastrointestinal injury,diaphragmatic injury,bile leakage,and liver function failure,developed during and after the operation.Complete tumor necrosis was achieved in all the 20 lesions(100%,20/20) on contrast-enhanced helical CT scans 1 month after the treatment.During a follow-up period of 5~31 months,symptoms completely disappeared in 13 patients and significantly subsided in 2 patients.Conclusions Laparoscopic radiofrequency ablation is a feasible,safe,and effective treatment for hepatic cavernous hemangioma complicating liver cirrhosis.