The use of cryotherapy for the treatment of some unresectable liver tumours has been clearlyestablished as a therapeutic option. Intra-operative ultrasound has enhanced the process by enablingthe surgeon to identify hepatic lesions and to allow visualisation of the freezing process to ensure thatthe cryolesion will include the tumour mass. The purpose of this paper is to provide a practical guide tosurgeons who wish to perform cryotherapy of liver tumours. Patient selection and anaestheticconsiderations are important. The surgeon should be able to deal with the complications ofcryotherapy, particularly the intra-operative haemorrhage which may arise from cracking of thehepatic parenchyma as the iceball thaws. Follow-up is based on tumour marker assay and imaging ofthe liver and repeat cryotherapy can be considered for selected cases.
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