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Radiofrequency Ablation of Liver Adjacent to Body of Gallbladder: Histopathologic Changes of Gallbladder Wall in a Pig Model

Jiwon Lee1,2, Hyunchul Rhim2, Yong Hwan Jeon1,2, Hyo K. Lim2, Won Jae Lee2, Dongil Choi2 and Young-sun Kim2

1 Department of Radiology, Kangwon National University College of Medicine, Kangwon-do, South Korea.
2 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, South Korea.


Figure 1
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  		Fig. 1A —Sonograms show method of electrode direction to gallbladder in pig liver. Shaft of electrode is placed parallel to long axis of gallbladder and active tip (arrows) is located about 0.5 cm from gallbladder wall (group Ap [parallel direction in group A]).

 

Figure 2
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  		Fig. 1B —Sonograms show method of electrode direction to gallbladder in pig liver. Radiofrequency electrode is placed in liver perpendicular in relation to gallbladder and active tip (arrows) is located about 1.0 cm from gallbladder wall (group Bpp [perpendicular direction in group B]).

 

Figure 3
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  		Fig. 2A —Photographs show specimens extracted from group A pig immediately after radiofrequency ablation with parallel direction (group Ai [immediate] and group Ap [parallel]). Serosal side of gallbladder wall (A) shows discoloration (arrows), but mucosal side (B) (represented by yellow color) of gallbladder wall shows necrosis (arrowheads).

 

Figure 4
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  		Fig. 2B —Photographs show specimens extracted from group A pig immediately after radiofrequency ablation with parallel direction (group Ai [immediate] and group Ap [parallel]). Serosal side of gallbladder wall (A) shows discoloration (arrows), but mucosal side (B) (represented by yellow color) of gallbladder wall shows necrosis (arrowheads).

 

Figure 5
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  		Fig. 3 —Photograph of specimen extracted from group A pig 7 days after radiofrequency ablation with parallel direction (group Ad [delayed] and group Ap [parallel]). On serosal side of gallbladder wall, greenish yellow color was noted because of frank perforation of gallbladder wall (arrows). Large area of radiofrequency ablation zone shows in liver abutting gallbladder.

 

Figure 6
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  		Fig. 4A —Photomicrographs of resected gallbladder immediately after radiofrequency ablation with parallel direction in group with 0.5-cm distance from gallbladder wall (group Ai [immediate] and group Ap [parallel]). Destruction of whole layer (arrows, A and B and red circle, A) of gallbladder wall and replacement with necrotic tissue in gallbladder wall are shown on low-power view (A) (H and E, x12.5) and high power view (B) (H and E, x40). Arrowheads and black circle represent viable muscle layer of gallbladder wall.

 

Figure 7
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  		Fig. 4B —Photomicrographs of resected gallbladder immediately after radiofrequency ablation with parallel direction in group with 0.5-cm distance from gallbladder wall (group Ai [immediate] and group Ap [parallel]). Destruction of whole layer (arrows, A and B and red circle, A) of gallbladder wall and replacement with necrotic tissue in gallbladder wall are shown on low-power view (A) (H and E, x12.5) and high power view (B) (H and E, x40). Arrowheads and black circle represent viable muscle layer of gallbladder wall.

 

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