Artificial ascites using the guidewire technique during microwave ablation in the liver dome: technique and analysis of fluid repartition.
Intervention
Liver
MWA
Thermoprotection
Journal
Abdominal radiology (New York)
ISSN: 2366-0058
Titre abrégé: Abdom Radiol (NY)
Pays: United States
ID NLM: 101674571
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
06
01
2021
accepted:
27
03
2021
revised:
22
03
2021
pubmed:
14
4
2021
medline:
7
9
2021
entrez:
13
4
2021
Statut:
ppublish
Résumé
To describe the guidewire technique to perform hydrodistension and create artificial ascites during liver microwave ablation (MWA) of tumors located in the hepatic dome and evaluate the effectiveness of repartition of peritoneal fluid along segments VII and VIII with this technique. A retrospective review of all 18 consecutive patients who benefited from MWA combined with hydrodistension causing artificial ascites performed with the guidewire technique was conducted. The technique involves inserting a 20G spinal needle in the liver parenchyma and catheterizing the peritoneum with a 0.018 nitinol guidewire while retrieving the needle from the liver. Technical success was defined by the successful insertion of a sheath over the wire in the peritoneal cavity and identification of peritoneal fluid on CT images, with repartition of ascites around segments VII and VIII. Target tumors were located in segments VII and VIII and had a mean size of 27.7 mm with a mean distance from the diaphragm of 1.7 mm. Technical success of artificial ascites was 14/18 (78%). In the four cases where artificial ascites failed, patients had undergone previous liver surgery. In the 14 cases for which artificial ascites were successful, complete separation of the diaphragm from the ablation zone was noted in 9/14 cases and partial separation in 5/14 cases. Hydrodistension with the guidewire technique is effective and safe to accomplish artificial ascites. The extent of repartition of peritoneal fluid is variable, especially in the peritoneal recess in contact with the bare area where diffusion of fluid was variable.
Identifiants
pubmed: 33846828
doi: 10.1007/s00261-021-03077-w
pii: 10.1007/s00261-021-03077-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4452-4459Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Garnon J, Cazzato RL, Caudrelier J, Nouri-Neuville M, Rao P, Boatta E, Ramamurthy N, Koch G, Gangi A. Adjunctive Thermoprotection During Percutaneous Thermal Ablation Procedures: Review of Current Techniques. Cardiovasc Intervent Radiol. 2019 Mar;42(3):344-357. https://doi.org/10.1007/s00270-018-2089-7 .
doi: 10.1007/s00270-018-2089-7
pubmed: 30310986
Wang CC, Kao JH. Artificial ascites is feasible and effective for difficult-to-ablate hepatocellular carcinoma. Hepatol Int. 2015 Oct;9(4):514-9. https://doi.org/10.1007/s12072-015-9639-8 .
doi: 10.1007/s12072-015-9639-8
pubmed: 26108302
Hsieh YC, Limquiaco JL, Lin CC, Chen WT, Lin SM. Radiofrequency ablation following artificial ascites and pleural effusion creation may improve outcomes for hepatocellular carcinoma in high-risk locations. Abdom Radiol (NY). 2019;44(3):1141-1151. doi: https://doi.org/10.1007/s00261-018-1831-6 .
doi: 10.1007/s00261-018-1831-6
pubmed: 30460530
Wang Y, Zhang L, Li Y, Wang W. Computed tomography-guided percutaneous microwave ablation with artificial ascites for problematic hepatocellular tumors. Int J Hyperthermia. 2020;37(1):256-262. https://doi.org/10.1080/02656736.2020.1736649 .
doi: 10.1080/02656736.2020.1736649
pubmed: 32157926
Rhim H, Lim HK. Radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm: the value of artificial ascites. Abdom Imaging. 2009 May-Jun;34(3):371-80. https://doi.org/10.1007/s00261-008-9408-4 .
doi: 10.1007/s00261-008-9408-4
pubmed: 18463915
Kang TW, Rhim H, Lee MW, Kim YS, Choi D, Lee WJ, Lim HK. Radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm: comparison of effects of thermal protection and therapeutic efficacy. AJR Am J Roentgenol. 2011;196(4):907-13. https://doi.org/10.2214/AJR.10.4584 .
doi: 10.2214/AJR.10.4584
pubmed: 21427344
Nam SY, Rhim H, Kang TW, Lee MW, Kim YS, Choi D, Lee WJ, Park Y, Chang I, Lim HK. Percutaneous radiofrequency ablation for hepatic tumors abutting the diaphragm: clinical assessment of the heat-sink effect of artificial ascites. AJR Am J Roentgenol. 2010 Feb;194(2):W227-31. https://doi.org/10.2214/AJR.09.2979 .
doi: 10.2214/AJR.09.2979
pubmed: 20093579
Bhagavatula SK, Chick JF, Chauhan NR, Shyn PB. Artificial ascites and pneumoperitoneum to facilitate thermal ablation of liver tumors: a pictorial essay. Abdom Radiol (NY). 2017 Feb;42(2):620-630. https://doi.org/10.1007/s00261-016-0910-9 . Review. PubMed
doi: 10.1007/s00261-016-0910-9.Review.PubMed
pubmed: 27665483
Kang TW, Lee MW, Hye MJ, Song KD, Lim S, Rhim H, Lim HK, Cha DI. Percutaneous radiofrequency ablation of hepatic tumours: factors affecting technical failure of artificial ascites formation using an angiosheath. Clin Radiol. 2014 Dec;69(12):1249-58. https://doi.org/10.1016/j.crad.2014.07.012 . Epub 2014 Aug 20.
doi: 10.1016/j.crad.2014.07.012
pubmed: 25149600
Abe T, Amano H, Takechi H, et al. Late-onset diaphragmatic hernia after percutaneous radiofrequency ablation of hepatocellular carcinoma: a case study. Surg Case Rep. 2016;2(1):25. https://doi.org/10.1186/s40792-016-0148-3
doi: 10.1186/s40792-016-0148-3
pubmed: 26976615
pmcid: 4791441
Nagasu S, Okuda K, Kuromatsu R, Nomura Y, Torimura T, Akagi Y. Surgically treated diaphragmatic perforation after radiofrequency ablation for hepatocellular carcinoma. World J Gastrointest Surg. 2017;9(12):281-287. doi: https://doi.org/10.4240/wjgs.v9.i12.281
doi: 10.4240/wjgs.v9.i12.281
pubmed: 29359034
pmcid: 5752963
Bonnin A, Durot C, Djelouah M, Dohan A, Arrivé L, Rousset P, Hoeffel C. MR Imaging of the Perihepatic Space. Korean J Radiol. 2020. doi: https://doi.org/10.3348/kjr.2019.0774 . Epub ahead of print.
Jiang L, Krishnasamy V, Varano GM, Wood BJ. Hyponatremia Following High-Volume D5W Hydrodissection During Thermal Ablation. Cardiovasc Intervent Radiol. 2016 Jan;39(1):146-9. https://doi.org/10.1007/s00270-015-1195-z . Epub 2015 Aug 6.
doi: 10.1007/s00270-015-1195-z
pubmed: 26246216
Huang Q, Li J, Zeng Q, Tan L, Zheng R, He X, Li K. Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery. BMC Cancer. 2020 Aug 14;20(1):763. https://doi.org/10.1186/s12885-020-07261-x .
doi: 10.1186/s12885-020-07261-x
pubmed: 32795279
pmcid: 7427902
Rhim H, Lim HK, Kim YS, Choi D. Percutaneous radiofrequency ablation with artificial ascites for hepatocellular carcinoma in the hepatic dome: initial experience. AJR Am J Roentgenol. 2008 Jan;190(1):91-8. https://doi.org/10.2214/AJR.07.2384 .
doi: 10.2214/AJR.07.2384
pubmed: 18094298
Song SG, Hur YH, Cho JY, Shin MH, Yoon EJ, Kim JW. Pleural Effusion after Hepatic Radiofrequency Ablation with Artificial Ascites: Clinical Spectrum and Significance. J Vasc Interv Radiol. 2020 Oct;31(10):1636-1644.e1. https://doi.org/10.1016/j.jvir.2020.06.001 . Epub 2020 Sep 14.
doi: 10.1016/j.jvir.2020.06.001
pubmed: 32943296
Pannu HK, Oliphant M. The subperitoneal space and peritoneal cavity: basic concepts. Abdom Imaging. 2015 Oct;40(7):2710-22. https://doi.org/10.1007/s00261-015-0429-5 .
doi: 10.1007/s00261-015-0429-5
pubmed: 26006061
pmcid: 4584112
Garnon J, Cazzato RL, Auloge P, Ramamurthy N, Koch G, Gangi A. Adjunctive hydrodissection of the bare area of liver during percutaneous thermal ablation of sub-cardiac hepatic tumours. Abdom Radiol (NY). 2020 Oct;45(10):3352-3360. https://doi.org/10.1007/s00261-020-02463-0 .
doi: 10.1007/s00261-020-02463-0
pubmed: 32211949
Isaza-Restrepo A, Martin-Saavedra JS, Velez-Leal JL, Vargas-Barato F, Riveros-Dueñas R. The Peritoneum: Beyond the Tissue - A Review. Front Physiol. 2018 Jun 15;9:738. https://doi.org/10.3389/fphys.2018.00738 .
doi: 10.3389/fphys.2018.00738