Complete Radio Frequency Ablation of Hepatocellular Carcinoma Adjacent to the Main Bile Duct and Blood Vessels Between the First and the Second Hepatic Portal

In cases where hepatocellular carcinoma cannot be surgically removed either due to the capacity of hepatic functional reserve or the special location of the tumor, a radiofrequency ablation (RFA) is recognized to be an effective and minimally invasive treatment. However, when the tumor is adjacent to the main bile duct and blood vessels, it is feared that due to the "heat-sink effect" of the blood and the possible damage to the duct and blood vessels, complete tumor ablation is hard to achieve. We report here a case of complete RFA of hepatocellular carcinoma, adjacent to the main bile duct and blood vessels between the first and the second hepatic portal, with emphasis on the safety of the approach for complete ablation of the tumor.