Abstract No. 339 - Can we freeze the gallbladder safely? Percutaneous cryoablation of hepatic masses adjacent to the gallbladder

Abstract

Purpose To report our 10-year experience of image-guided percutaneous cryoablation of hepatic tumors near the gallbladder. Materials and Methods Twenty-one cryoablation procedures were performed to treat 19 hepatic tumors adjacent to the gallbladder in 17 patients (11 male, mean age: 59.2 years, range: 40-82) under CT or MR guidance in this IRB approved, HIPPA compliant retrospective study. All tumors (mean size 2.67 cm, range 1.0 - 5.0 cm) were within 1cm of the gallbladder (mean 0.4 cm), with 7 (33%) tumors contiguous with the gallbladder. Variables analyzed included tumor size and distance to the gallbladder on preablation MRI, and ice ball propagation through the gallbladder wall on intraprocedural CT (n=15) or MRI (n=6). Complication rate, technical success, and technique effectiveness were assessed. Results In 19 (90%) of 21 procedures, monitoring scans revealed iceball extension into the lumen of the gallbladder. Complications occurred in 6 (29%) of 21 procedures, of which 1 (5%) was major (DIC). None of the complications were related to the gallbladder. The most common post-procedure gallbladder abnormalities at 24-hour imaging were mild focal wall edema or thickening after 9 (42%) of 21 procedures. Technical success was achieved in 19 (90%) of 21 sessions. Of the 17 patients with 3-month follow-up, no local recurrence was observed. Conclusion Hepatic tumors adjacent to the gallbladder can be treated safely and effectively with image-guided percutaneous cryoablation even when the iceball extends into the gallbladder lumen.