Electrolytic liver ablation is not associated with evidence of a systemic inflammatory response syndrome

• Published in: British journal of surgery Vol. 91; no. 2; pp. 178 - 183
• Main Authors: Teague, B. D., Court, F. G., Morrison, C. P., Kho, M., Wemyss-Holden, S. A., Maddern, G. J.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.02.2004; Wiley
• Subjects: Alanine Transaminase - metabolism; Alkaline Phosphatase - metabolism; Animals; Biological and medical sciences; C-Reactive Protein - analysis; Catheter Ablation - methods; Electrolysis - methods; Female; General aspects; Interleukin-1 - blood; Liver - enzymology; Liver Neoplasms - surgery; Medical sciences; Platelet Count; Risk Factors; Serum; Swine; Systemic Inflammatory Response Syndrome - blood; Systemic Inflammatory Response Syndrome - enzymology; Systemic Inflammatory Response Syndrome - etiology; Tumor Necrosis Factor-alpha - analysis; Medicine; Association; Treatment; Surgery; Liver; Inflammation; Systemic; Disseminated; Ablation; Syndrome
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.4400

Background Local ablation has been proposed for treatment of liver tumours. Cryoshock, a variant of the systemic inflammatory response syndrome (SIRS), is a potentially fatal complication of cryoablation caused by systemic release of necrotic breakdown products from ablated liver. The proinflammatory cytokines tissue necrosis factor (TNF) α and interleukin (IL) 1 are important mediators of this response. This study assessed the risk of SIRS complicating electrolytic liver ablation by measuring circulating levels of inflammatory cytokines, other inflammatory markers and clinical markers of organ function. Methods Electrolytic liver ablation was performed in 16 pigs and four pigs served as controls. Platelet count, and serum levels of urea, creatinine, liver enzymes, C‐reactive protein (CRP), TNF‐α and IL‐1β were measured before treatment and for 72 h after the procedure. Results There were significant dose‐related increases in CRP and alanine aminotransferase levels with liver electrolysis. There was no significant derangement in renal function or platelet count following ablation. A rise in serum TNF‐α and IL‐1β levels was not associated with liver electrolysis. Conclusion There was no evidence of organ failure or significantly raised levels of proinflammatory cytokines as a result of liver electrolysis, suggesting that this is a safe procedure for liver ablation. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. More evidence to support this novel method of tissue ablation