Cardiovascular and interventional radiology · 2026
Who is Afraid of the Gallbladder? Case Series of Unmitigated Pericholecystic Microwave Ablations of Liver Tumours with Pictorial Review.
СтатьяНазвание и аннотация: Перевод в очереди
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Pisano Umberto, Kay David Hunter
Аннотация
PURPOSE: Thermal ablation of liver tumours is widely established. A location in vicinity of the gallbladder (GB) usually causes apprehension. Our intention was to gather data from our day-to-day practice to assess whether pericholecystic tumours can be ablated safely without protective measures.
MATERIALS AND METHODS: Retrospective review of patient series undergoing microwave ablation of primary and secondary pericholecystic liver tumours (segments IVb-V) without hydro-pneumodissection between September 2018 and September 2025, in which the ablation zone encompassed the GB wall. Outcomes are technical success (> 5 mm safety margins), complication rate, hospital stay length, postoperative pain, modified gastrointestinal symptoms rating scale (mGSRS) score at 24h, rate of 30-day hospital readmission 3-, 6-, 12-month local tumour progression-free survival (LTPFS).
RESULTS: Forty-eight patients were included; 34 (70.8%) were males. Average age was 67 years (SD ± 10.2). Hepatocellular carcinoma was the most common diagnosis. Twenty-six (54.2%) procedures were performed on a single lesion near GB. Technical success was 100%. No severe complications were seen. Average pain score was 1.9 (SD ± 1.8; median 1, IQR 0.75-2.25), and mGSRS score was 8.6 (SD ± 5.8; median 7.5 IQR 4-11); average hospital stay length was 1.9 days (SD ± 2.3; median 1 day; IQR 1-2 days). Four patients (8.3%) required readmission: 1 (2.1%) due to delayed cholecystitis (treated conservatively) and 3 (6.3%) due to pain, but no additional intervention. 3-, 6-, 12-month LTPFS was 94%, 89% and 80%.
CONCLUSION: The incidence of GB injury was low in this series, and the procedures were well tolerated. A protective hydro- or pneumodissection was found to be not essential.
MATERIALS AND METHODS: Retrospective review of patient series undergoing microwave ablation of primary and secondary pericholecystic liver tumours (segments IVb-V) without hydro-pneumodissection between September 2018 and September 2025, in which the ablation zone encompassed the GB wall. Outcomes are technical success (> 5 mm safety margins), complication rate, hospital stay length, postoperative pain, modified gastrointestinal symptoms rating scale (mGSRS) score at 24h, rate of 30-day hospital readmission 3-, 6-, 12-month local tumour progression-free survival (LTPFS).
RESULTS: Forty-eight patients were included; 34 (70.8%) were males. Average age was 67 years (SD ± 10.2). Hepatocellular carcinoma was the most common diagnosis. Twenty-six (54.2%) procedures were performed on a single lesion near GB. Technical success was 100%. No severe complications were seen. Average pain score was 1.9 (SD ± 1.8; median 1, IQR 0.75-2.25), and mGSRS score was 8.6 (SD ± 5.8; median 7.5 IQR 4-11); average hospital stay length was 1.9 days (SD ± 2.3; median 1 day; IQR 1-2 days). Four patients (8.3%) required readmission: 1 (2.1%) due to delayed cholecystitis (treated conservatively) and 3 (6.3%) due to pain, but no additional intervention. 3-, 6-, 12-month LTPFS was 94%, 89% and 80%.
CONCLUSION: The incidence of GB injury was low in this series, and the procedures were well tolerated. A protective hydro- or pneumodissection was found to be not essential.