COMPLICATIONS OF HEPATIC CRYOSURGERY

Cryosurgery may be considered for patients whose hepatic lesions are n ot amenable to surgical resection, i.e., patients with multiple hepati c lesions and/or lesions abutting major vascular structures. Because t he size of the iceball created during the procedure can be carefully c ontrolled. cryosurgery has the advantage of being a focal technique th at spares much more noncancerous liver tissue than surgical resection. The major complications of hepatic cryosurgery are the same as those of hepatic resection: hemorrhage, pleural effusion, bile leak fistula, perihepatic abscess, and hepatic failure. In addition, there is a ris k of coagulopathy when large tumors are frozen using multiple freeze-t haw cycles. In general, operative morbidity is related to the volume o f frozen tissue, the number of freeze-thaw cycles, and number of cryop robes. Further experience and accrual of long-term data should better define the indications for hepatic cryosurgery and minimize the incide nce of complications. (C) 1998 Wiley-Liss, Inc.