Complications of hepatic cryosurgery.
Cryosurgery may be considered for patients whose hepatic lesions are not amenable to surgical resection, i.e., patients with multiple hepatic lesions and/or lesions abutting major vascular structures. Because the size of the iceball created during the procedure can be carefully controlled, cryosurgery has the advantage of being a focal technique that spares much more noncancerous liver tissue than surgical resection. The major complications of hepatic cryosurgery are the same as those of hepatic resection: hemorrhage, pleural effusion, bile leak fistula, perihepatic abscess, and hepatic failure. In addition, there is a risk of coagulopathy when large tumors are frozen using multiple freeze-thaw cycles. In general, operative morbidity is related to the volume of frozen tissue, the number of freeze-thaw cycles, and number of cryoprobes. Further experience and accrual of long-term data should better define the indications for hepatic cryosurgery and minimize the incidence of complications.
Sarantou
T
T
John Wayne Cancer Institute, Saint John's Health Center, Santa Monica, California 90404, USA.
Bilchik
A
A
Ramming
K P
KP
D058186:Acute Kidney Injury / Q000209:etiology; D001658:Biliary Fistula / Q000209:etiology; D003452:Cryosurgery / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008099:Liver / Q000293:injuries; D008100:Liver Abscess / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D010976:Platelet Count; D010996:Pleural Effusion / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D013921:Thrombocytopenia / Q000209:etiology