Ultrasound-guided percutaneous microwave coagulation therapy with a "cooled-tip needle" for the treatment of hepatocellular carcinoma adjacent to the gallbladder

Abstract

Background: Curative percutaneous microwave coagulation therapy is difficult or contraindicated in patients with tumors adjacent to the gallbladder because of the associated risk of injury. To date, no clinical data have been published regarding the effects and safety of percutaneous microwave coagulation therapy on tumors that are adjacent to the gallbladder.

Aims: We investigated the efficacy and safety of a combined treatment involving laparoscopic cholecystectomy and subsequent percutaneous microwave coagulation therapy in patients with hepatocellular carcinoma adjacent to the gallbladder.

Methods: Twenty-three patients with hepatocellular carcinoma nodules (of less than 5 cm diameter) and adjacent to the gallbladder were treated by percutaneous microwave coagulation therapy with a "cooled-tip needle" after laparoscopic cholecystectomy. The therapeutic efficacy was evaluated with enhanced helical computed tomography and sonography, and the rates of complete necrosis as well as postoperative complications were also analyzed.

Results: All of the patients exhibited complete necrosis of their tumor lesions after treatment with percutaneous microwave coagulation therapy. During the follow-up period (which lasted more than 21 months), 22 of 23 patients were alive. Recurrent nodules appeared in other subsegments, but not at the original site treated with percutaneous microwave coagulation therapy. Of note, no fatal complications were observed in any of the patients treated with percutaneous microwave coagulation therapy.

Conclusion: Our results suggest that combined treatment comprising both laparoscopic cholecystectomy and subsequent percutaneous microwave coagulation therapy is an effective and safe approach for patients with small (<5 cm) hepatocellular carcinomas that are adjacent to the gallbladder.