Feasibility, safety, and efficacy of ultrasound-guided percutaneous microwave ablation for giant hepatic hemangioma

Abstract

(2018) Feasibility, safety, and efficacy of ultrasound-guided percutaneous microwave ablation for giant hepatic

TAE Combined with Microwave Ablation in the Treatment of Rare Giant Hepatic Hemangioma:Case Report and Literature Review

“…However, giant hemangiomas larger than 5 cm in diameter may cause compression symptoms, such as obstructive jaundice, gastric outlet obstruction, and Budd-Chiari syndrome, or coagulopathy (Kasabach-Merritt syndrome) requiring further intervention [10] . The current treatments include surgery, interventional therapy [3] , radiofrequency and microwave ablation [4] . TAE is a common method used for the treatment of hepatic hemangioma.…”

“…With the deepening of the concept of minimally invasive and rapid rehabilitation, exploring the minimally invasive treatment of hepatic hemangioma is a hot topic. In recent years, there have been many studies on interventional therapy [3] and ablation of hepatic hemangioma [4] . However, the safety and effect of interventional therapy and ablation on hepatic hemangioma need to be con rmed by further study [5] .…”

Current concepts in ablative procedures for primary benign liver lesions: a step forward to minimize the invasiveness of treatment when deemed necessary

“…In all the 17 studies, reviewed diagnosis of HH was confirmed by imaging based on the typical enhancement pattern on contrast-enhanced CT, MR or contrast-enhanced ultrasound (CEUS). In one study by Wang et al, preprocedural blood tests were performed to exclude malignant neoplasm (AFP, CEA and CA19-9) [15]. Indication to resort to ablative percutaneous strategies were mostly homogeneous among the considered studies, including the presence of "large/giant" HH associated to persistent-related symptoms in patients refusing open or laparoscopic surgical resection.…”

“…In 4 out of 17 studies, authors performed preprocedural peritoneal saline infusion (hydrodissection) to provide a satisfactory sonographic window and to protect nontarget structures (diaphragm, abdominal wall, colon, gallbladder) while ablating lesions abutting the Glisson capsule or the diaphragm [15,17,[23][24][25].…”

“…Wang and Cheng described the development of post-ablation systemic inflammatory response (SIR) in 50% and 75.7% of patients, respectively, within two days after intervention [14,19]. Wang and colleagues reported low fever, constipation, slight wound pain, stomach discomfort and other MWA minor postoperative reactions in 11 out of 12 treated patients [15]. Transient and rapidly resolving liver dysfunction, manifesting as elevation of serum alanine transaminase and aspartate transaminase (> 80 U/L) and jaundice do to indirect hyperbilirubinemia over 3 mg/dl were described in three studies [18,23,25].…”