Artificial Ascites a Problem-solving Technique in Primary Hepatic Tumor Radiofrequency Ablation

Background: Primary liver malignancies are not uncommon especially in Egypt due the high prevalence of virus B and C. Treatment options include surgical option (transplantation, hepatectomy) and less invasive option (RF, microwave, TACE and TARE). RF is a very good treatment option which is equivalent to hepatectomy yet less invasive in patient with lesions less than 3 cm (Barcelona Clinic Liver Cancer, 2016). RF is avoided when the lesion is near bowel or in the liver dome hidden by the lung. Artificial ascites is considered as valuable problem solving technique for these limitations. Methods: Before ablation of 21 peripherally located hepatic tumors near adjacent bowel, intra peritoneal infusion of adequate amount glucose 5% using 18 G needle aiming for adequate tumor bowel separation to avoid thermal injury of gastrointestinal tract. Results: Technical success with was done adequate separation in more than ninety percent of the patient with safe tumor ablation. One patient with failure of separation which was likely attributed to peritoneal adhesion subsequent to previous surgery. No serious complication. None of the patient required post operative diuretics. Conclusions: Production of artificial ascites is a safe technique with no major technical complication nor post operative thermal bowel injury or adhesions. It is safe effective technique to feasible delivery of radiofrequency ablation of hepatic tumor near gastrointestinal tract avoiding major surgery in lesion less that 3 cm (hepatectomy).

Publication History

Article published online:
26 April 2021