Multipolar Radiofrequency Ablation for Hepatocellular Carcinoma Using Extra Nodular Versus Intranodular Technique

Exclusion Criteria

• •Adult patient under guardianship or trusteeship, homeless
• •Patient with potentially short term life-threatening serious co-infection (apart from viral B or C, or VIH co-infection)
• •Pregnant or breastfeeding woman
• •Patient for whom regular follow-up is impossible whatever the cause
• •Contra indication to general anaesthesia
• •Technical impossibility to perform the procedure under ultrasound guidance
• •Boundary of the tumor located at less than 1 cm distance from colonic wall or main biliary tract (main right or left bill ducts and common bill duct)
• •Tumor invisible with ultrasound
• •Lack of safe percutaneous course which can be planned
• •Tumor in which more than four biopsies pass were previously performed (cumulated during one or several previous biopsies sessions)
• •Contra indication to perform CT or MRI with contrast medium (GADOLINITE or iodinate) intravenous injection
• •Child-Pugh B or C cirrhosis (apart from the transitory liver failures in the setting of acute hepatitis related to alcohol abuse)
• •Total detachment of the anterior face of the liver from internal abdominal wall due to abundant ascites.
• •Prothrombin activity \< 50 %
• •Platelet count \<40 .10 3/ml
• •Platelet dysfunction or congenital impaired blood coagulating