Biliary Lesions during Radiofrequency Ablation in Liver

Marchal, Frédéric; Elias, D.; Rauch, Philippe; Leroux, Agnès; Stines, J.; Verhaeghe, Jean-Luc; Guillemin, Françis; Villemot, Jean Pierre

doi:10.1159/000076648

Cited by 28 publications

(15 citation statements)

References 23 publications

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“…Ablation to within 1 cm of the major bile ducts (common bile duct, common hepatic, right and left hepatic ducts) runs the risk of bile duct injury [51]. The secondary effects, cholangitis and liver abscesses can be very significant, particularly if the patient requires chemotherapy at some later date.…”

Section: Relationship To Central Bile Ductsmentioning

confidence: 99%

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

et al. 2015

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Objectives Previous attempts at meta-analysis and systematic review have not provided clear recommendations for the clinical application of thermal ablation in metastatic colorectal cancer. Many authors believe that the probability of gathering randomised controlled trial (RCT) data is low. Our aim is to provide a consensus document making recommendations on the appropriate application of thermal ablation in patients with colorectal liver metastases. Methods This consensus paper was discussed by an expert panel at The Interventional Oncology Sans Frontières 2013. A literature review was presented. Tumour characteristics, ablation technique and different clinical applications were considered and the level of consensus was documented.Eur Radiol (2015) Results Specific recommendations are made with regard to metastasis size, number, and location and ablation technique. Mean 31 % 5-year survival post-ablation in selected patients has resulted in acceptance of this therapy for those with technically inoperable but limited liver disease and those with limited liver reserve or co-morbidities that render them inoperable.Conclusions In the absence of RCT data, it is our aim that this consensus document will facilitate judicious selection of the patients most likely to benefit from thermal ablation and provide a unified interventional oncological perspective for the use of this technology. Key Points• Best results require due consideration of tumour size, number, volume and location.• Ablation technology, imaging guidance and intraprocedural imaging assessment must be optimised.• Accepted applications include inoperable disease due to tumour distribution or inadequate liver reserve.• Other current indications include concurrent co-morbidity, patient choice and the test-of-time approach.• Future applications may include resectable disease, e.g. for small solitary tumours.

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Section: Relationship To Central Bile Ductsmentioning

confidence: 99%

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

et al. 2015

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“…While various mouse, rat, guinea pig, dog and pig models have been developed and evaluated at some level, they appear most useful at identifying mechanisms of sensitization and elicitation [106,107,108,109,110,111]. Each model has proven highly reactive for some specific allergens, but they have either not been tested with a variety of allergenic and non-allergenic proteins, or they have been shown to react with non-allergenic proteins.…”

Section: Animal Modelsmentioning

confidence: 99%

Assessing Genetically Modified Crops to Minimize the Risk of Increased Food Allergy: A Review

Goodman

Hefle

Taylor

et al. 2005

Int Arch Allergy Immunol

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The first genetically modified (GM) crops approved for food use (tomato and soybean) were evaluated for safety by the United States Food and Drug Administration prior to commercial production. Among other factors, those products and all additional GM crops that have been grown commercially have been evaluated for potential increases in allergenic properties using methods that are consistent with the current understanding of food allergens and knowledge regarding the prediction of allergenic activity. Although there have been refinements, the key aspects of the evaluation have not changed. The allergenic properties of the gene donor and the host (recipient) organisms are considered in determining the appropriate testing strategy. The amino acid sequence of the encoded protein is compared to all known allergens to determine whether the protein is a known allergen or is sufficiently similar to any known allergen to indicate an increased probability of allergic cross-reactivity. Stability of the protein in the presence of acid with the stomach protease pepsin is tested as a risk factor for food allergenicity. In vitro or in vivo human IgE binding are tested when appropriate, if the gene donor is an allergen or the sequence of the protein is similar to an allergen. Serum donors and skin test subjects are selected based on their proven allergic responses to the gene donor or to material containing the allergen that was matched in sequence. While some scientists and regulators have suggested using animal models, performing broadly targeted serum IgE testing or extensive pre- or post-market clinical tests, current evidence does not support these tests as being predictive or practical. Based on the evidence to date, the current assessment process has worked well to prevent the unintended introduction of allergens in commercial GM crops.

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“…Dabei kann es zu intrahepatischen Einblutungen bzw. Blutungen in die freie Bauchhöhle mit den Folgen eines akuten Blutverlustes, Austritt von Gallenflüssigkeit und Stenosierungen von Gallengängen mit nachfolgenden ikterischen oder septischen Reaktionen kommen [6,7]. Blutungen um den Applikator führen zudem zu einer Karbonisation, die die Eindringtiefe der Photonen limitiert und das Koagulationsvolumen begrenzt [4].…”

Section: Introductionunclassified

Laserinduzierte Thermotherapie (LITT) von Lebertumoren in zentraler Lokalisation: Ergebnisse und Komplikationen

Mensel

Weigel²,

Cd³

et al. 2005

Rofo Fortschr Geb Rontgenstr N

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Biliary Lesions during Radiofrequency Ablation in Liver

Cited by 28 publications

References 23 publications

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

Assessing Genetically Modified Crops to Minimize the Risk of Increased Food Allergy: A Review

Laserinduzierte Thermotherapie (LITT) von Lebertumoren in zentraler Lokalisation: Ergebnisse und Komplikationen

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