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Updated: May 19, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Bile aspiration and hydrodissection to prevent complications in hepatic RFA close to the gallbladder
Elena Levit1, Philipp Bruners, Rolf W Günther
1Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Aachen, Germany.
Background:
Radiofrequency ablation (RFA) of liver tumors is a mainstay of interventional oncology. Its application, however, is limited by tumor size and location with lesions located within 1 cm to the gallbladder being at increased risk for complications.
Purpose:
To evaluate the safety of hepatic RFA after bile aspiration with or without additional hydrodissection for lesions adjacent to the gallbladder.
Material And Methods:
Six patients undergoing RFA of tumors with a distance of less than 1 cm to the gallbladder were retrospectively identified from a computer database. All patients underwent RFA combined with percutaneous bile aspiration from the gallbladder. In four patients additional hydrodissection was performed. Technical success and post-interventional complications were assessed by reviewing images and patient charts.
Results:
Ablations were successfully completed in 5/6 patients. In one patient with incomplete ablation re-ablation was performed 2 months after the initial procedure. Minor complications occurred in three patients, including right-sided pleural effusion, hematoma in the gallbladder fossa, and intralesional hemorrhage in one patient each. There were no cases with cholecystitis or damage to the gallbladder during follow-up.
Conclusion:
Bile aspiration with or without additional hydrodissection permits safe RFA of tumors located close to the gallbladder.
