Role of Artificial Ascites Pre-Radiofrequency Ablation of Sub Capsular Liver Tumors

Abstract
Background: Radiofrequency ablation for liver tumours is a common practice because of its many advantages including feasibility, relatively low cost, being a day case procedure, and minimal invasiveness. Sub-capsular hepatomas manage-ment represents a challenge due to liability of thermal injury to major organs and occurrence of serious complications.
Aim of Study: To assess the safety and technical efficacy of percutaneous radiofrequency ablation after artificial ascites in sub-capsular hepatoma.
Methods: In our study, 18 patients had hydro dissection procedure done to facilitate ultrasound guided Radiofrequency Ablation (RFA) for sub-capsular hepatic lesions. Hydro dissection was performed with 5% dextrose in water to displace adjacent structures away from the liver capsule. RFA system with cluster or single internally cooled electrodes were used for treatment of hepatic malignancies. The feasibility, safety, and efficacy of this technique were assessed on follow-up.
Results: Our patients' mean age was 59.6 years old. No major complications related to hydro dissection were recorded. One of our patients had a thermal injury (5.5%). No patients suffered from biliary injury, haemorrhage or tumour seeding. Mean hydro dissection displacement of nearby organs was 1.6cm.
Conclusion: Hydro-dissection (artificial ascites) proved to improve technical efficacy and safety for ultrasound guided radiofrequency of sub-capsular hepatomas.