Concurrent Liver Ablation and Paracentesis in Patients with Preexisting Ascites

Hanna Thompson discusses her CIO2023 abstract, "CIO 2023-27 Concurrent Liver Ablation and Paracentesis in Patients with Preexisting Ascites."

Read the full abstract and view poster here

Concurrent Liver Ablation and Paracentesis in Patients with Preexisting Ascites from HMP on Vimeo.

My name is Hannah Thompson. I'm a 4th year medical student from the University of Louisville, and I'm here today to talk about my poster, concurrent liver ablation, and paracentesis in patients with preexisting ascites. So many patients, when they come in for radiofrequency ablation for treatment of hepatocellular carcinoma, also have concurrent ascites

As a complication of their disease, we wanted to investigate whether or not draining that UID, would lead to any increased risks in the procedure, especially since ascites is sometimes artificially created as a protective mechanism before radiofrequency ablation. So the kind of the thought behind to the ascites is that it would create a protective barrier, that would kind of prevent any inadvertent ablation of non target structures or vascular injuries. We looked at 10 cases of patients with hepatocellular carcinoma who underwent therapeutic paracentesis immediately prior to radio frequency ablation.

These patients had hepatocellular carcinoma, targets in all quinade segments except, segment 5, including 5 lesions that were very close to the diaphragm and one that was close to the stomach. Even though up to 10 liters of fluid was drained in these pre procedural paracentesis, no Sanguinis output was detected suggesting lack of vascular injury and then no injuries to adjacent organs like the bowel, Or any other inverting structures were damaged. So we believe that paracentesis appears very safe to perform, either concurrently or immediately prior to RFA, and then the creation of the artificial ascites prior to the procedure may not actually be necessary to protect these non target structures from ablation. We also propose that Any type of sanguineous output from the paracentesis could suggest vascular injury and facilitate immediate intervention, in paracentesis that's performed with radiofrequency ablation.