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Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma: Assessment of Safety in Patients With Ascites

¹ All authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Gangnam-Gu, Seoul 135-710, Korea.

OBJECTIVE. The objective of our study was to assess whether percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is a safe procedure in patients with ascites.

MATERIALS AND METHODS. From October 2005 to January 2008, 35 patients with one or more HCCs and ascites were referred to our department for planning sonography of RFA. In 15 patients, RFA was determined to be unfeasible. One patient was excluded from the study because of the absence of ascites at the time of RFA. Percutaneous ultrasound-guided RFA was performed in the remaining 19 patients with 24 HCCs. The electrode tract was cauterized at the time of electrode removal. Retrospective assessments of the preprocedural platelet counts and prothrombin times were performed, and patients were evaluated for bleeding complication by checking vital signs, checking serum hemoglobin level, and using CT to determine whether the attenuation value of ascites had increased > 30 HU.

RESULTS. There were no cases of mortality or major complications that developed after RFA. No significant difference in the maximum thickness of the perihepatic ascites and in the hemoglobin level between the pre- and postprocedural measurements was detected. Hemoperitoneum as a minor complication was noted in two (10.5%) of 19 patients. However, in those two patients, vital signs were stable, follow-up laboratory data were normal, and hemoperitoneum had been completely absorbed on CT images obtained 1 month after RFA.

CONCLUSION. Percutaneous RFA for HCC can be performed safely in patients with ascites.

Keywords: ascites • cirrhosis • contraindication • hemoperitoneum • hepatocellular carcinoma • imaging-guided tumor ablation • radiofrequency ablation

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