Ultrasound-guided percutaneous thermal and non-thermal ablation of intrahepatic cholangiocarcinoma

Ultrasound-guided percutaneous thermal ablation has gained popularity as treatment for malignant hepatic tumors. It was first introduced as ablation therapy for hepatocellular carcinoma and cirrhosis comorbidity. Recently, this technique has also been used in the treatment of intrahepatic cholangiocarcinoma for patients who are not eligible for surgical resection. There are several types of thermal ablation techniques. Radiofrequency ablation and microwave ablation are two common methods that induce necrosis of the lesions. Irreversible electroporation is a relatively new non-thermal technique and is suitable in cases where thermal ablation would be ineffective or dangerous (e.g., malignant tumors close to vascular or biliary structures). Irreversible electroporation can induce tumoral necrosis without damage to vascular and biliary structures. The aim of this minireview was to describe the safety, efficacy, and clinical indications of these techniques in the treatment of patients with intrahepatic cholangiocarcinoma who are ineligible for surgery.