Radiofrequency ablation of hepatic tumors adjacent to the gallbladder: feasibility and safety.

ABSTRACT

OBJECTIVE: This study was performed to assess the feasibility and safety of radiofrequency ablation of hepatic tumors adjacent to the gallbladder. MATERIALS AND METHODS: Of the 83 patients who underwent radiofrequency ablation of hepatic tumors at our institution between December 1997 and August 2000, we identified eight patients--four men and four women who were 42-85 years old (mean age, 67 years)--who had tumors adjacent to the gallbladder. All ablations were performed with curative intent. We reviewed the patients' preablation imaging, radiofrequency ablation parameters, and course after ablation. Follow-up ranged from 3 to 22 months (mean, 8 months). RESULTS: Six patients with colorectal carcinoma and two with hepatocellular carcinoma had a total of 14 tumors adjacent to the gallbladder. Of the 14 tumors, nine (64%) were metastases and five (36%) were hepatocellular carcinoma. Eleven tumors (79%) were located directly adjacent to the gallbladder and three (21%) were located within 1 cm of the gallbladder. Tumor size ranged from 0.9 to 4.5 cm (mean, 3.6 cm). The number of radiofrequency ablations performed on each tumor ranged between one and six (mean, three ablations). Right upper quadrant pain developed in the immediate postablation period (within 7 days after the ablation) in six patients (75%) and ranged in duration from 5 to 21 days (mean, 7 days). Fever developed in four patients (50%), with a mean duration of 5 days. Arthralgia and right shoulder pain developed in one patient (12%). No deaths were noted in the immediate period after ablation. Complete ablation of all tumors visible on CT was achieved in seven patients. Of these, one patient (14%) had local tumor recurrence after 11 months. CONCLUSION: Radiofrequency ablation of tumors adjacent to the gallbladder is feasible and appears to be safe. Self-limited morbidity after ablation is noted in most patients and is probably related to a mild iatrogenic cholecystitis.