Abdominal Cryosurgery

  • Nikolai N. Korpan


Foremost among the most important areas in which cryosurgery is used are primary and secondary curative and inoperable liver tumors. Liver cryosurgery is a new method of treatment, in which the tumorous lesion is ablated in situ by means of a cryosurgical instrument. In recent years a new path has opened up for patients with liver tumors thanks to cryosurgery. No more than 25% of patients with an isolated liver tumor have conventional surgery. Of these, 20–35% achieve 5-year survival.


Liver Metastasis Liver Tumor Extrahepatic Disease Fibrous Capsule Porta Hepatis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Korpan NN, Zharkov JV, Sacher R. A morphological study of cooling rate response in normal animal liver tissue: Cryosurgical Implications. Europ J Clin Invest 1999; 29 (Suppl 1): 22.Google Scholar
  2. 2.
    Adam R, Akpinar E, Johann M, Kunstlinger F, Majno P, Bismuth H. Place of Cryosurgery in the Treatment of Malignant Liver Tumors. Ann Surg 1997; 225 (1): 39–50.PubMedCrossRefGoogle Scholar
  3. 3.
    Korpan NN. Hepatic Cryosurgery for Liver Metastases. Long-Term Follow-Up. Ann Surg 1997; 225 (2): 193–201.CrossRefGoogle Scholar
  4. 4.
    Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology 1998; 37 (3): 171–186.PubMedCrossRefGoogle Scholar
  5. 5.
    McKinnon G, Temple WJ, Wiseman DA, Saliken JC. Cryosurgery for malignant tumors of the liver. Can J Surg 1996; 39 (5): 401–406.PubMedGoogle Scholar
  6. 6.
    Korpan NN, Hochwarter G. Pancreatic cryosurgery — a new surgical procedure for pancreatic cancer. Eur J Clin Invest 1997; 27 (Suppl 1): A33.Google Scholar
  7. 7.
    Korpan NN. The use of low temperatures in oncology. In: The low temperatures in medicine (Ed. Ternovoi KS, Gassanov LG) 145–162 (Naukova Dumka, Kyiv, 1988).Google Scholar
  8. 8.
    Korpan NN. Möglichkeiten und Grenzen der modernen Kryochirurgie. In: Was gibt es Neues in der Medizin. Medizinisches Jahrbuch (Ed. Neugebauer H.), 207–213 (Dr. Peter Müller Verlag-Wien, 1996).Google Scholar
  9. 1.
    Healey WV, Priebe CJ, Jr., Farrer SM, Phillips LL. Hepatic cryosurgery. Acute and long-term effects. Arch Surg 1971; 103 (3): 384–392.PubMedCrossRefGoogle Scholar
  10. 2.
    Dutta P, Montes M, Gage AA. Experimental hepatic cryosurgery. Cryobiology 1977; 14 (5): 598–608.PubMedCrossRefGoogle Scholar
  11. 3.
    Dutta P, Montes M, Gage AA. Large volume freezing in experimental hepatic cryosurgery. Avoidance of bleeding in hepatic freezing by an improvement in the technique. Cryobiology 1979; 16(1): 50–55.PubMedCrossRefGoogle Scholar
  12. 4.
    Ravikumar TS, Steele G, Jr., Kane R, King V. Experimental and clinical observations on hepatic cryosurgery for colorectal metastases. Cancer Res 1991; 51(23 Pt 1): 6323–6327.Google Scholar
  13. 5.
    Sarantou T, Bilchik A, Ramming KP. Complications of hepatic cryosurgery. Semin Surg Oncol 1998; 14 (2): 156–162.PubMedCrossRefGoogle Scholar
  14. 6.
    Bilchik AJ, Sarantou T, Foshag LJ, Giuliano AE, Ramming KP. Cryosurgical palliation of metastatic neuroendocrine tumors resistant to conventional therapy. Surgery 1997; 122 (6): 1040–1047.PubMedCrossRefGoogle Scholar
  15. 7.
    Seifert JK, Morris DL. Prognostic factors after cryotherapy for hepatic metastases from colorectal cancer. Ann Surg 1998; 228 (2): 201–208.PubMedCrossRefGoogle Scholar
  16. 8.
    Onik GM, Chambers N, Chernus SA, Zemel R, Atkinson D, Weaver ML. Hepatic cryosurgery with and without the Bair Hugger. J Surg Oncol 1993; 52 (3): 185–187.PubMedCrossRefGoogle Scholar
  17. 9.
    Cady B, Jenkins RL, Steele GD, Jr., Lewis WD, Stone MD, McDermott WV et al. Surgical margin in hepatic resection for colorectal metastasis: a critical and improvable determinant of outcome. Ann Surg 1998; 227 (4): 566–571.PubMedCrossRefGoogle Scholar
  18. 10.
    Seifert JK, Morris DL. World survey on the complications of hepatic and prostate cryotherapy. World J Surg 1999; 23 (2):109–113.PubMedCrossRefGoogle Scholar
  19. 11.
    Yeh KA, Fortunato L, Hoffman JP, Eisenberg BL. Cryosurgical ablation of hepatic metastases from colorectal carcinomas. Am Surg 1997; 63 (1): 63–68.PubMedGoogle Scholar
  20. 12.
    Berney T, Mentha G, Roth AD, Morel P. Results of surgical resection of liver metastases from non-colorectal primaries. Br J Surg 1998; 85 (10): 1423–1427.PubMedCrossRefGoogle Scholar
  21. 13.
    Weaver ML, Ashton JG, Zemel R. Treatment of colorectal liver metastases by cryotherapy. Semin Surg Oncol 1998; 14 (2): 163–170.PubMedCrossRefGoogle Scholar
  22. 14.
    Silverstein JC, Staren E, Velasco J. Thermal bile duct protection during liver cryoablation. J Surg Oncol 1997; 64 (2): 163–164.PubMedCrossRefGoogle Scholar
  23. 15.
    Frank JL, Navab F, Ly K, Reed WP, Jr. Hemobilia complicating hepatic cryosurgery. J Surg Oncol 1998; 67 (2): 130–133.PubMedCrossRefGoogle Scholar
  24. 16.
    Cozzi PJ, Englund R, Morris DL. Cryotherapy treatment of patients with hepatic metastases from neuroendocrine tumors. Cancer 1995; 76 (3): 501–509.PubMedCrossRefGoogle Scholar
  25. 17.
    Stewart GJ, Preketes A, Horton M, Ross WB, Morris DL. Hepatic cryotherapy: double-freeze cycles achieve greater hepatocellular injury in man. Cryobiology 1995; 32 (3): 215–219.PubMedCrossRefGoogle Scholar
  26. 18.
    Blackwell TS, Debelak JP, Venkatakrishnan A, Schot DJ, Harley DH, Pinson CW et al. Acute lung injury after hepatic cryoablation: correlation with NF-kappa B activation and cytokine production. Surgery 1999; 126 (3): 518–526.PubMedCrossRefGoogle Scholar
  27. 19.
    Seifert JK, Junginger T, Morris DL. A collective review of the world literature on hepatic cryotherapy. J R Coll Surg Edinb 1998; 43 (3): 141–154.PubMedGoogle Scholar
  28. 20.
    Tandan VR, Harmantas A, Gallinger S. Long-term survival after hepatic cryosurgery versus surgical resection for metastatic colorectal carcinoma: a critical review of the literature. Can J Surg 1997; 40 (3): 175–181.PubMedGoogle Scholar
  29. 21.
    Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999; 80 (6): 827–841.PubMedCrossRefGoogle Scholar
  30. 22.
    Zhou XD, Tang ZY. Cryotherapy for primary liver cancer. Semin Surg Oncol 1998; 14 (2): 171–174.PubMedCrossRefGoogle Scholar
  31. 23.
    Mazziotti A, Grazi GL, Cavallari A. Surgical treatment of hepatocellular carcinoma on cirrhosis: a Western experience. Hepatogastroenterology 1998; 45 Suppl 3: 1281–1287.PubMedGoogle Scholar
  32. 24.
    Wong WS, Patel SC, Cruz FS, Gala KV, Turner AF. Cryosurgery as a treatment for advanced stage hepatocellular carcinoma: results, complications, and alcohol ablation. Cancer 1998; 82 (7): 1268–1278.PubMedCrossRefGoogle Scholar
  33. 25.
    Korpan NN. Hepatic cryosurgery for liver metastases. Long-term follow-up. Ann Surg 1997; 225 (2): 193–201.PubMedCrossRefGoogle Scholar
  34. 26.
    Robertson JM, Lawrence TS, Walker S, Kessler ML, Andrews JC, Ensminger WD. The treatment of colorectal liver metastases with conformal radiation therapy and regional chemotherapy. Int J Radiat Oncol Biol Phys 1995; 32 (2): 445–450.PubMedCrossRefGoogle Scholar
  35. 27.
    Bertuccelli M, Falcone A, Campoccia S, Conti M, Brunetti I, Caramella D et al. Intrahepatic chemotherapy with floxuridine, leucovorin and dexamethasone in continuous infusion and mitomycin-C bolus in unresectable hepatic metastases from colorectal cancer: a phase II study. Tumori 1999; 85 (6): 473–477.PubMedGoogle Scholar
  36. 28.
    Howell JD, Warren HW, Anderson JH, Kerr DJ, McArdle CS. Intraarterial 5-fluorouracil and intravenous folinic acid in the treatment of liver metastases from colorectal cancer. Eur J Surg 1999; 165 (7): 652–658.PubMedCrossRefGoogle Scholar
  37. 29.
    Kemeny N, Conti JA, Cohen A, Campana P, Huang Y, Shi WJ et al. Phase II study of hepatic arterial floxuridine, leucovorin, and dexamethasone for unresectable liver metastases from colorectal carcinoma. J Clin Oncol 1994; 12 (11): 2288–2295.PubMedGoogle Scholar
  38. 30.
    Que FG, Nagorney DM, Batts KP, Linz LJ, Kvols LK. Hepatic resection for metastatic neuroendocrine carcinomas. Am J Surg 1995; 169 (1): 36–42.PubMedCrossRefGoogle Scholar
  39. 31.
    McEntee GP, Nagorney DM, Kvols LK, Moertel CG, Grant CS. Cytoreductive hepatic surgery for neuroendocrine tumors. Surgery 1990; 108 (6): 1091–1096.PubMedGoogle Scholar
  40. 32.
    Grazi GL, Cescon M, Pierangeli F, Ercolani G, Gardini A, Cavallari A et al. Highly aggressive policy of hepatic resections for neuroendocrine liver metastases [In Process Citation]. Hepatogastroenterology 2000; 47 (32): 481–486.PubMedGoogle Scholar
  41. 33.
    Elias D, Cavalcanti dA, Eggenspieler P, Plaud B, Ducreux M, Spielmann M et al. Resection of liver metastases from a noncolorectal primary: indications and results based on 147 monocentric patients. J Am Coll Surg 1998; 187 (5): 487–493.PubMedCrossRefGoogle Scholar
  42. 34.
    Chamberlain RS, Canes D, Brown KT, Saltz L, Jarnagin W, Fong Y et al. Hepatic neuroendocrine metastases: does intervention alter outcomes? J Am Coll Surg 2000; 190 (4): 432–445.PubMedCrossRefGoogle Scholar
  43. 35.
    Seifert JK, Cozzi PJ, Morris DL. Cryotherapy for neuroendocrine liver metastases. Semin Surg Oncol 1998; 14 (2): 175–183.PubMedCrossRefGoogle Scholar
  44. 36.
    Maksan SM, Lehnert T, Bastert G, Herfarth C. Curative liver resection for metastatic breast cancer. Eur J Surg Oncol 2000; 26 (3): 209–212.PubMedCrossRefGoogle Scholar
  45. 37.
    Selzner M, Morse MA, Vredenburgh JJ, Meyers WC, Clavien PA. Liver metastases from breast cancer: long-term survival after curative resection. Surgery 2000; 127 (4): 383–389.PubMedCrossRefGoogle Scholar
  46. 38.
    Adam R, Akpinar E, Johann M, Kunstlinger F, Majno P, Bismuth H. Place of cryosurgery in the treatment of malignant liver tumors. Ann Surg 1997; 225 (1): 39–8.PubMedCrossRefGoogle Scholar
  47. 39.
    Crews KA, Kuhn JA, McCarty TM, Fisher TL, Goldstein RM, Preskitt JT. Cryosurgical ablation of hepatic tumors. Am J Surg 1997; 174 (6): 614–617.PubMedCrossRefGoogle Scholar
  48. 40.
    Wren SM, Coburn MM, Tan M, Daniels JR, Yassa N, Carpenter CL et al. Is cryosurgical ablation appropriate for treating hepatocellular cancer? Arch Surg 1997; 132 (6): 599–603.PubMedCrossRefGoogle Scholar
  49. 41.
    Bilchik AJ, Sarantou T, Wardlaw JC, Ramming KP. Cryosurgery causes a profound reduction in tumor markers in hepatoma and noncolorectal hepatic metastases. Am Surg 1997; 63 (9): 796–800.PubMedGoogle Scholar
  50. 42.
    Lam CM, Yuen WK, Fan ST. Hepatic cryosurgery for recurrent hepatocellular carcinoma after hepatectomy: a preliminary report. J Surg Oncol 1998; 68 (2): 104–106.PubMedCrossRefGoogle Scholar
  51. 43.
    Dale PS, Souza JW, Brewer DA. Cryosurgical ablation of unresectable hepatic metastases. J Surg Oncol 1998; 68 (4): 242–245.PubMedCrossRefGoogle Scholar
  52. 44.
    Ravikumar TS, Kane R, Cady B, Jenkins R, Clouse M, Steele G, Jr. A 5-year study of cryosurgery in the treatment of liver tumors. Arch Surg 1991; 126 (12): 1520–1523.PubMedCrossRefGoogle Scholar
  53. 1.
    Littrup P, Lee F, Rajan D. Hepatic cryotherapy. State of the art techniques and future developments. Ultrasound Quarterly 1998; 14: 171–188.CrossRefGoogle Scholar
  54. 2.
    Weaver Ml, Atkinson D, Zemel R. Hepatic cryosurgery in the treatment of unresectable metastases. Surg Oncol 1995; 4: 231–236.PubMedCrossRefGoogle Scholar
  55. 3.
    Morris DL, Ross WB, Iqbal J. Cryoablation of hepatic malignancy: an evaluation of tumor marker data and survival in 110 patients. GL Cancer 1996; 1: 247–251.Google Scholar
  56. 4.
    Ravikumar TS, Kane R, Cady B. A 5 year study of cryosurgery in the treatment of liver tumors. Arch Surg 1991; 126: 1520–1524.PubMedCrossRefGoogle Scholar
  57. 5.
    Korpan NN. Hepatic cryosurgery for liver metastases. Annals Surg 1997; 225: 193–201.CrossRefGoogle Scholar
  58. 6.
    Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver: the prognosis for patients with hepatic metastases from colonic carcinoma by laparotomy. Cancer 1969; 23: 198–202.PubMedCrossRefGoogle Scholar
  59. 7.
    Wood CB, Gillis CR, Blumgart LH. A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol 1976; 2: 285–288.PubMedGoogle Scholar
  60. 8.
    Bengtsson G, Caelsson G, Hafstrom L, Jonsson PE. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg 1981; 141: 586–589.PubMedCrossRefGoogle Scholar
  61. 9.
    Steele G Jr, Ravikumar TS. Resection of hepatic metastases from colorectal cancer: biologic perspectives. Ann Surg 1989; 210: 127–138.PubMedCrossRefGoogle Scholar
  62. 10.
    Onik GM, Cooper C, Goldberg HI, Moss AA, Rubinsky B, Christianson M. Ultrasonic characteristics of frozen liver. Cryobiology 1984; 21: 321–328.PubMedCrossRefGoogle Scholar
  63. 11.
    Onik G, Rubinsky B, Zemel R, et al. Ultrasound-guided hepatic cryosurgery in the treatment of colorectal metastatic colon carcinoma: preliminary results. Cancer 1991; 67: 901–907.PubMedCrossRefGoogle Scholar
  64. 12.
    Ravikumar TS. The role of cryotherapy in the management of patients with liver tumors. Adv Surg 1996; 30: 281–291.PubMedGoogle Scholar
  65. 1.
    Lee FT, Jr., Chosy SG, Weber SM, Littrup PJ, Warner TF, Mahvi DM. Hepatic cryosurgery via minilaparotomy in a porcine model: an alternative to open cryosurgery. Surg Endosc 1999; 13 (3): 253–259.PubMedCrossRefGoogle Scholar
  66. 2.
    Tandan VR, Litwin D, Asch M, Margolis M, Gallinger S. Laparoscopic cryosurgery for hepatic tumors. Experimental observations and a case report. Surg Endosc 1997; 11 (11): 1115–1117.PubMedCrossRefGoogle Scholar
  67. 3.
    Cuschieri A, Crosthwaite G, Shimi S, Pietrabissa A, Joypaul V, Tair I. Hepatic cryotherapy for liver tumors. Development and clinical evaluation of a high-efficiency insulated multineedle probe system for open and laparoscopic use. Surg Endosc 1995; 9 (5): 483–489.PubMedCrossRefGoogle Scholar
  68. 4.
    McCall JL, Jorgensen JO, Morris DL. Laparoscopic hepatic cryotherapy: a study of safety in rabbits. Surg Laparosc Endosc 1996; 6 (1): 29–31.PubMedCrossRefGoogle Scholar
  69. 5.
    Iannitti DA, Heniford T, Hale J, Grundfest-Broniatowski S, Gagner M. Laparoscopic cryoablation of hepatic metastases. Arch Surg 1998; 133 (9): 1011–1015.PubMedCrossRefGoogle Scholar
  70. 6.
    Wallis CB, Coventry DM. Anaesthetic experience with laparoscopic cryotherapy. A new technique for treating liver metastases. Surg Endosc 1997; 11 (10): 979–981.PubMedCrossRefGoogle Scholar
  71. 7.
    Pistorius G, Menger MD, Feifel G. Minilaparotomy vs the percutaneous approach for minimally invasive hepatic cryosurgery [letter]. Surg Endosc 2000; 14 (2): 207–209.PubMedCrossRefGoogle Scholar
  72. 8.
    Heniford BT, Area MJ, Iannitti DA, Walsh RM, Gagner M. Laparoscopic cryoablation of hepatic metastases. Semin Surg Oncol 1998; 15 (3): 194–201.PubMedCrossRefGoogle Scholar
  73. 9.
    Lezoche E, Paganini AM, Feliciotti F, Guerrieri M, Lugnani F, Tamburini A. Ultrasound-guided laparoscopic cryoablation of hepatic tumors: preliminary report. World J Surg 1998; 22 (8): 829–835.PubMedCrossRefGoogle Scholar
  74. 1.
    Alperovich BI. Alveococcosis. Yacutsk, Russia, 1967.Google Scholar
  75. 2.
    Alperovich BI. Alveococcosis and its treatment. Medicine, Moscow, 1972.Google Scholar
  76. 3.
    Alperovich BI, Paramonova LM, Merzlikin NV. Cryosurgery of the liver and pancreas. Tomsk, Tomsk State University Press, 1985.Google Scholar
  77. 4.
    Alperovich BI. Surgery of the liver. Tomsk, Tomsk State University Press, 1985.Google Scholar
  78. 5.
    Alperovich BI. Liver and biliary tract surgery. Tomsk, Siberian Medical University, 1997.Google Scholar
  79. 6.
    Bregadze IL, Konstantinov VM. Alveolar echinococcosis. Medgis, USSR, 1963.Google Scholar
  80. 7.
    Dederer YM, Krylova NP. Atlas of operations on the liver. Medicine, Moscow, 1975.Google Scholar
  81. 8.
    Bruns P. Leberresection bei multilokulaerem Echinococcosis. Beitr. f.klin.Chir., 1896; 50 (7): 1353.Google Scholar
  82. 9.
    Cooper IS. Cryogenic Surgery. Engineering in the Practice of Medicine. Baltimore, 1967.Google Scholar
  83. 10.
    Reifferscheid M. Chirurgie der Leber. Stuttgart, 1957.Google Scholar
  84. 11.
    Stucke K. Zur chirurgischen Therapie der Echinococcus alveolaris. Der Chirurg, 1963; 34: 165.Google Scholar
  85. 1.
    Alperovich BI. Surgery of liver and bile ducts. Tomsk, Siberian State Medical University, 1997.Google Scholar
  86. 2.
    Alperovich BI, Paramonova LM, Merslikin NV. Cryosurgery of the liver and pancreas. Tomsk, Tomsk State University, 1985.Google Scholar
  87. 3.
    Askerhanov RP. Surgery of echinococcosis. Makhachkala, Dagestan Publishing House, 1976.Google Scholar
  88. 4.
    Petrovsky BV, Milonov OB, Deyenichin PG. Surgery of echinococcosis. Moscow, Medicina, 1985.Google Scholar

Copyright information

© Springer-Verlag Wien 2001

Authors and Affiliations

  • Nikolai N. Korpan

There are no affiliations available

Personalised recommendations