Liver ablation is a medical procedure to treat tumors within the liver. It involves inserting a device into the tumor to destroy cancerous tissue using various energy sources. This minimally invasive method is often performed through a small incision. Its primary aim is to eliminate the tumor while minimizing harm to surrounding healthy liver tissue.
Why Liver Ablation is Performed
Liver ablation is often considered for individuals with liver tumors who are not candidates for traditional surgical removal. This includes patients with primary liver tumors, like hepatocellular carcinoma (HCC), especially in early stages. It also treats metastatic tumors that have spread to the liver from other organs, such as colorectal metastases. The procedure treats tumors limited in number and size (generally less than 3-5 centimeters) and is an option for patients with health conditions making extensive surgery risky.
In some cases, liver ablation complements other therapies or serves as a “bridge” to liver transplantation, controlling tumor growth while a patient awaits a transplant. This targeted approach destroys cancerous cells while preserving healthy liver function. A multidisciplinary team assesses the patient’s health, tumor characteristics, and potential benefits to decide on liver ablation.
Different Methods of Liver Ablation
Several techniques use distinct energy sources to destroy tumor cells. Radiofrequency ablation (RFA) uses high-energy radio waves to generate heat, destroying the tumor. A thin, needle-like probe is inserted into the tumor, and an electric current heats the cancerous tissue. Microwave ablation (MWA) operates similarly, using microwave energy to produce heat for tumor destruction. Both RFA and MWA are thermal ablation types, using heat to achieve their effect.
Cryoablation, in contrast, destroys tumors by freezing them. This method involves guiding a thin metal probe into the tumor, circulating very cold gases to freeze and destroy cancer cells. Percutaneous ethanol injection (PEI) directly injects pure alcohol (ethanol) into the tumor to destroy cancer cells. These procedures are performed under imaging guidance (ultrasound, CT, or MRI) to ensure precise probe placement and monitor the ablation zone.
Preparing for and Recovering from Liver Ablation
Preparation for liver ablation involves steps to ensure patient safety and procedure effectiveness. Patients may undergo pre-procedure tests, and medication adjustments, especially for blood thinners, might be necessary. Fasting instructions are usually provided, requiring no food or drink after midnight the night before. Patients are often admitted to the hospital on the day of ablation.
Following the procedure, patients are monitored in a recovery area, with pain and nausea managed by medication. Most individuals experience discomfort at the incision site or dull pain in the abdomen or right shoulder (referred pain). Fatigue and flu-like symptoms, known as post-ablation syndrome, can also occur and may last one to two weeks. While some patients may be discharged the same day, an overnight hospital stay is common, and a responsible adult should provide transportation home. Strenuous activities, including heavy lifting, are generally restricted for a few days to weeks; patients are advised to rest and gradually increase activity.
What to Expect Long-Term
After recovering from liver ablation, long-term care focuses on monitoring the liver and detecting potential recurrence. Follow-up appointments are scheduled, typically including imaging scans (CT or MRI) to assess treatment effectiveness and check for new tumor growth. These scans are often performed within four to six weeks after the procedure, then periodically (e.g., every three to six months for the first year or two).
While liver ablation effectively destroys tumors, recurrence is possible, either at the treated site or in other parts of the liver. The risk of recurrence is influenced by factors like tumor size and type. Ongoing surveillance is important to detect recurrence early, allowing for further treatment if needed. The overall management plan involves a healthcare team to ensure the best long-term outcomes.