개복하 고주파열치료(Radiofrequency Ablation) 후 발생한 합병증 증례 ; 개복하 고주파열치료 후 발생한 발열, 혈소판 감소증 및 간기능 저하

Abstract

The surgical resection is the only curative modality for hepatocellular carcinoma (HCC); however the surgical approach is limited by residual function of liver and multiplicity of tumor. The radiofrequency ablation (RFA) is introduced recently as a therapeutic modality, an alternative to percutaneous ethanol injection therapy (PEIT) for HCC. The advantages of open surgical RFA include better cancer staging with open intraoperative ultrasound, the availability of an intraoperative ultrasound guide system, the accessibility to tumors in all areas of the liver, avoidance of adjacent organ injury, the ability to perform hepatic inflow occlusion which reduces the heat-sink effect, and the possibility of combining RFA with hepatic resection. The complications after open surgical radiofrequency ablation are rarely reported. A 59 year old man with fever, thrombocytopenia and the deterioration of liver function after open surgical RFA was experienced. The patient’s hepatic function was given a Child-Pugh score of A6 points and the value of ICG R15 test was 55.2%. The open surgical RFA was performed on the S2, S3, S4 and S8. Although the patient was fully recovered without sequelae by conservative managements, the inclusion criteria have to be established carefully through following reviews on clinical results after open surgical RFA.