Microwave ablation in the spleen for treatment of secondary hypersplenism: a preliminary study

The purpose of this study is to evaluate the feasibility, safety, and efficacy of microwave (MW) ablation for the treatment of hypersplenism, via a laparoscopic or percutaneous approach, and its effect on liver function in patients with liver cirrhosis.

Twenty patients (17 men and three women; mean age, 51.7 ± 11.4 years; age range, 31-68 years) with secondary hypersplenism resulting from liver cirrhosis were treated with MW ablation of splenic parenchyma (13 laparoscopically and seven percutaneously with ultrasound guidance). Splenic volume and ablated volume were calculated according to contrast-enhanced CT scan. Routine blood counts (platelet, leukocyte, and erythrocyte counts) and liver function test results were examined before and after MW ablation.

The mean follow-up period was 26.4 ± 11.4 months (range, 6-48 months). After MW ablation, the ablation ratio ranged from 16% to 58% (mean, 30.9% ± 13%). All patients showed an increase in platelet count and leukocyte count after MW ablation, and patients with an ablation ratio greater than 40% showed more sustainable increase of platelet count in the follow-up period. Serum total protein levels significantly increased (p < 0.05). No severe complications occurred.

MW ablation is a safe and effective technique for the management of hypersplenism in patients with liver cirrhosis. Ablating more than 40% of the splenic parenchyma may yield better long-term results.