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. 2010:2010:403097.
doi: 10.1155/2010/403097. Epub 2010 Aug 30.

Radiomorphology of the Habib sealer-induced resection plane during long-time followup: a longitudinal single center experience after 64 radiofrequency-assisted liver resections

Robert Kleinert  1 , Roger Wahba, Christoph Bangard, Klaus Prenzel, Arnulf H Hölscher, Dirk Stippel
Affiliations

Radiomorphology of the Habib sealer-induced resection plane during long-time followup: a longitudinal single center experience after 64 radiofrequency-assisted liver resections

Robert Kleinert et al. HPB Surg. 2010.

Abstract

Background: Radiofrequency (RF-) assisted liver resection devices like the Habib sealer induce a necrotic resection plane from which a small margin of necrotic liver tissue remains in situ. The aim of the present paper was to report our long-time experience with the new resection method and the morphological characteristics of the remaining necrotic resection plane.

Methods: 64 RF-assisted liver resections were performed using the Habib sealer. Followup was assessed at defined time points.

Results: The postoperative mortality was 3,6% and morbidity was 18%. The followup revealed that the necrotic zone was detectable in all analyzed CT and MRI images as a hypodense structure without any contrast enhancement at all time points, irrespectively of the time interval between resection and examination.

Conclusion: Liver resection utilizing radiofrequency-induced resection plane coagulation is a safe alternative to the established resection techniques. The residual zone of coagulation necrosis remains basically unchanged during a followup of three years. This has to be kept in mind when evaluating the follow up imaging of these patients.

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Figures

Figure 1
Figure 1
Probes were positioned in the liver parenchyma. A necrosis of healthy parenchyma measuring 1 cm in width was induced. The liver parenchyma was then dissected with a scalpel near the proximal margin of the 1-cm wide necrotic zone.
Figure 2
Figure 2
The necrotic zone (marked blue) was isolated using an edge detection-based segmentation algorithm and rendered to a three-dimensional object (left image). The four images on the left side represent the object from different views.
Figure 3
Figure 3
CT scans 15 days (a), 6 months (b), and 20 months (c) after liver resection for HCC in cirrhotic liver.
Figure 4
Figure 4
3D reconstruction of the liver 15 days (a) and 20 months (b) after liver resection for HCC. The necrotic margin is yellow colored and is not detached during regeneration.
See this image and copyright information in PMC

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