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目的评估腹腔镜下对毗邻胆囊的肝细胞癌进行一次性完全射频消融(RFA)治疗的可行性与安全性。方法选取毗邻胆囊周边不同部位的肝细胞癌患者5例,肿瘤直径2.5～4.2cm,采用腹腔镜辅助射频消融治疗,腹腔镜下对胆囊不作分离与切除,射频消融过程保中持胆囊壁的连续完整。术后通过B超及CT了解肿瘤有无复发,并观察患者生存状况。结果术后3d行B超检查见胆囊壁近消融区处边缘增厚,厚度0.3～0.5cm,CT显示胆囊壁密度增高。术后6个月增强CT显示5例患者肿瘤边缘均无强化,胆囊完整,达到肿瘤一次性完全消融。随访18～36个月,所有患者均生存良好。结论腹腔镜下对毗邻胆囊的肝细胞癌达到一次性完全消融并保持胆囊壁的连续与完整在技术上是安全可行的。
Objective To evaluate the feasibility and safety of laparoscopic one-time complete radiofrequency ablation (RFA) of hepatocellular carcinoma adjacent to the gallbladder. Methods Five patients with hepatocellular carcinoma adjacent to different parts of the gallbladder were selected. The diameter of the tumor was 2.5-4.2cm. Laparoscopic assisted radiofrequency ablation was used. Laparoscopic treatment of the gallbladder was not performed. The gallbladder wall was preserved in radiofrequency ablation complete. After surgery by B ultrasound and CT to understand tumor recurrence, and observe the survival of patients. Results The B-mode ultrasonography showed that the edge of the gallbladder wall near the ablation zone was thickened at a thickness of 0.3-0.5 cm. CT showed an increase in the density of the gallbladder wall. At 6 months after operation, enhanced CT showed no enhancement of the tumor margin and complete gallbladder in 5 patients, achieving a one-time complete ablation of the tumor. All cases were followed up for 18-36 months. All patients survived well. Conclusion Laparoscopic hepatobiliary carcinoma adjacent to the gallbladder to achieve a one-time complete ablation and to maintain the continuity and integrity of the gallbladder wall is technically safe and feasible.