Hepatic Cryosurgery

Abstract

A liquid nitrogen cryoprobe was used to freeze 49 hepatic lobes in 34 dogs. Absolute hemostasis in deep liver fractures occurred during the frozen state. With thawing, bleeding ensued and was controlled with sutures in 22 animals. These did well after freezing of up to 350 cc of hepatic parenchyma. A "sterile infarct" was produced which was sharply demarcated from the surrounding normal tissue and then slowly resorbed without evidence of toxic effects. Only minimal scar tissue was present in four to six months. Eleven animals exsanguinated in the first 24 hours postoperatively (no transfusions, no hemostatic agents, no tissue excised). Changes in clotting factors suggested that disseminated intravascular coagulation may have occurred immediately after the necrosis produced by freezing. Thus, freezing produced temporary, not permanent, hemostasis in the severely injured canine liver.