Radiofrequency ablation of the liver abutting stomach: In vivo comparison of gastric injury before and after intragastric saline administration in a porcine model

Abstract

Purpose: To compare the in vivo gastric injury observed during radiofrequency (RF) ablation of the liver abutting the stomach before and after the intragastric administration of chilled saline. Materials and methods: Twenty RF ablation zones were created in the livers of 10 pigs with a 1-cm-exposed active tip of an internally cooled electrode under ultrasound guidance for 10 min. Ten RF ablation zones were created before (non-saline group) and after (saline group) the intragastric administration of approximately 1000 mL of chilled saline, and 20 RF ablation zones were made in the posterior part of the left lobe abutting the stomach. The frequency and severity of the thermal injury observed in the stomach of the two groups were compared histologically. Results: All the resected gastric specimens showed thermal injuries of varying degrees of severity. The largest diameter of the gastric injury was significantly smaller in the saline group (mean 1.5 cm; range 1.3-1.8 cm) than in the non-saline group (mean 2.1 cm; range 1.8-2.4 cm) (p = 0.000). The saline group showed significantly less thermal injury to the muscular layer of the gastric wall by the histopathology (p = 0.033). Conclusions: The intragastric administration of chilled saline might be a useful technique for reducing the severity of gastric injury during RF ablation of the liver abutting the stomach. (C) 2008 Elsevier Ireland Ltd. All rights reserved.