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Complications of radiofrequency ablation in hepatocellular carcinoma

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Abstract

Radiofrequency thermal ablation has been accepted as a promising technique to treat unresectable liver tumors. However, any interventional procedure should be performed only if the procedure is safe, with minimal morbidity and mortality rates. Recently, three separate multicenter surveys have reported acceptable morbidity and mortality rates for a minimally invasive technique. The mortality rate ranged from 0.1% to 0.5%, the major complication rate ranged from 2.2% to 3.1%, and the minor complication rate ranged from 5% to 8.9%. The most common causes of death were sepsis and hepatic failure, and the most common complications were intraperitoneal bleeding, hepatic abscess, bile duct injury, hepatic decompensation, and grounding pad burns. Minor complications and side effects are more common than major complications, but most of them are transient and self-limiting. Several strategies for avoiding or limiting the impact of complications after radiofrequency ablation are recommended: (a) careful patient selection, (b) combined treatment with other techniques when appropriate, (c) selection of the most appropriate guiding modality and approach, and (d) early detection and appropriate management of any major complications. Knowledge of the broad spectrum of complications and relevant management enables the operator to minimize the incidence and effect of any complications that occur after radiofrequency ablation.

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Acknowledgments

I deeply appreciate the contributions of the following members of the Korean Study Group of Radiofrequency Ablation for excellent cases of complications: Dongil Choi, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea; Pyo Nyun Kim, Ulsan University, Asan Medical Center, Seoul, Korea; Cheol Min Park, Korea University Hospital, Seoul, Korea; Yun Hwan Kim, Korea University Hospital, Seoul, Korea; Kwon-Ha Yoon, Wonkwang University Hospital, Iksan, Korea; Yoonkoo Cho, Korean Veterans Hospital, Seoul, Korea; and Young-Sun Kim, Hanyang University Guri Hospital, Guri, Korea.

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  1. Department of Diagnostic Radiology, Hanyang University Hospital, 17 Haengdang-Dong, Sungdong-Ku, Seoul, 133-792, Korea

    H. Rhim

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Rhim, H. Complications of radiofrequency ablation in hepatocellular carcinoma. Abdom Imaging 30, 409–418 (2005). https://doi.org/10.1007/s00261-004-0255-7

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