Application of radiofrequency ablation in anatomical hepatectomy / 中华普通外科杂志

ABSTRACT

Objective To evaluate radiofrequency ablation in anatomical hepatectomy.Methods The clinical data of 57 patients undergoing anatomical hepatectomy with radiofrequency ablation (radiofrequency ablation group) from Jul 2010 to May 2013 in Tangdu Hospital were compared with those 57 cases using traditional clamp crushing resection during the same period.Results There was no mortality perioperatively.Intraoperative duration of liver dissection,haemorrhage volume of liver dissection,blood transfusion volume,Pringle manoeuvre,postoperative alanine aminotransferase (ALT) in the third and fifth day in the radiofrequency ablation group were (65 ±30) min,(195 ± 107) ml,(150 ±80) ml,7 cases (12.3％),(309 ±226) U/L and (164 ±82) U/L respectively,which were statistically different from those of (50 ±40) min,(255 ± 180) ml,(205 ± 120) ml,45 (78.9％),(388 ± 174) U/L and (220 ± 156) U/L in clamp crushing resection group (seperately t =2.266,-2.158,-2.880,x2 =51.060,t =-2.090,-2.403,all P ＜ 0.05).Large branches of hepatic vein (caliber ≥ 7 mm) were injuried by mistake 7 times in radiofrequency group,there was no massive blood loss.Postoperative biliary fistula developed in two cases.There was no ablation included thrombus.In radiofrequency group,and Pringle manoeuvre was used in hemihepatic resection in 7 patients.Conclusions Radiofrequency ablation is not recommended to dissecting large caliber vessels (≥ 7 mm) for fear of causing thrombus.Radiofrequency ablation in anatomical hepatectomy,when used properly,is safe and effective.