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What Is Liver Ablation?

Liver ablation is a minimally invasive technique employed for managing both primary and metastatic liver lesions. This procedure involves using heat, cold, or electrical energy to destroy tumors in the liver, providing an alternative to surgery with potentially shorter recovery times and fewer complications.

How Is It Treated?

The concept behind liver ablation involves the targeted application of focal heat or, in some cases, cold temperatures to eliminate cancer cells. The primary objective is to create an ablation margin surrounding the tumor, effectively ensuring that no cancer cells remain. This approach is particularly suited for treating lesions that are smaller than 3 cm and typically involves no more than 3-4 individual lesions. Liver ablation offers a precise and effective method for managing localized liver tumors, providing an alternative to surgery with favorable outcomes, especially in cases where lesions are limited in size and number.

Types of Ablative Therapies

There are several types of ablative therapies available for treating various medical conditions. One common method is radiofrequency ablation (RFA), which employs high-frequency electrical currents to generate heat and destroy abnormal tissues. Another approach is microwave ablation (MWA), which utilizes microwave energy to produce heat and achieve tissue destruction. Cryoablation, on the other hand, involves freezing tissues to induce cell death and is often used in the treatment of tumors or abnormal growths. Additionally, irreversible electroporation (IRE) utilizes electrical pulses to create nanopores in cell membranes, leading to cell death. Each of these ablative therapies offers unique advantages and may be tailored to suit specific patient needs and medical situations.

Liver Ablation Procedure

The liver ablation procedure is commonly conducted under the guidance of CT and/or ultrasound imaging, with patients typically receiving general anesthesia or conscious sedation for comfort. The total duration of the procedure typically spans around two hours. However, the actual ablation or burning time is usually quite brief, lasting only a few minutes and contingent upon factors such as the size and number of lesions being treated. This approach ensures precise targeting and effective treatment while minimizing patient discomfort and procedural time.

Recovery

Following the procedure, patients are usually discharged after a few hours of observation. Over-the-counter pain medications are commonly prescribed, with occasional use of stronger narcotics, and low-dose steroids for several days to manage discomfort and inflammation. Patients may experience post-ablation syndrome, characterized by symptoms such as lethargy, malaise, and low-grade fever, typically lasting 24-48 hours and typically beginning a few days after the procedure.

Follow Up

After the liver ablation procedure, follow-up imaging is scheduled at the one-month mark, usually consisting of a multiphase CT scan of the liver with and without contrast. Patients then attend a clinic appointment to review the imaging results and discuss the subsequent steps in their treatment plan. In a small percentage of cases, typically less than 3%, a touch-up ablation may be necessary to address any residual disease. Continued follow-up imaging is recommended over the next five years to monitor for any changes or recurrence. If you have liver cancer or metastatic cancer to the liver and wish to explore potential liver-directed therapies, please schedule an appointment for evaluation.