Reply

Excerpt

I have been asked by the editors to respond to a recent letter [1] addressing my comments on a publication on RFA-assisted hepatectomy by Mitsuo et al. [2]. The letter raises an important point and describes the authors’ results with a large number of laparoscopic radiofrequency ablation (RFA) procedures for hepatic tumors. The authors point out that the level of serum hepatocellular enzymes after laparoscopic RFA are typically 10- to 14-fold higher than normal and that they have not seen any bile leaks in a large number of cases. They also mention that bile leaks from RFA of intrahepatic tumors are a result of heat injury to major bile ducts in the central part of the liver. The authors’ conclude that elevation of liver function tests after RFA is inconsequential. Clearly, the authors’ well-known data make the point that RFA of intrahepatic tumors is safe if performed at a distance from major bile ducts and that elevation of liver function tests are not clinically relevant in that setting. …