Clinical Report: Intraoperative Irreversible Electroporation for iCCA

Overview

This case series evaluates the feasibility and safety of intraoperative irreversible electroporation (IRE) as an adjunct to extended hepatectomy in patients with advanced intrahepatic cholangiocarcinoma (iCCA).

Background

Intrahepatic cholangiocarcinoma (iCCA) is increasingly prevalent and associated with poor prognosis, with surgical resection being the only potentially curative option. However, many patients present with advanced disease, limiting surgical eligibility. Irreversible electroporation (IRE) is a non-thermal ablative modality that enables tissue treatment while preserving vascular structures.

Data Highlights

Key Findings

• All procedures were completed as planned without intraoperative complications.
• No IRE-related postoperative adverse events were observed.
• Preserved hepatic vein patency was confirmed in all patients postoperatively.
• No local recurrence at the vascular interface was detected at a median follow-up of 18 months.
• One patient developed a solitary intrahepatic recurrence, successfully treated with local ablation.
• All patients were alive at the last follow-up.

Clinical Implications

Intraoperative IRE may serve as an adjunct to extended hepatectomy in patients with locally advanced iCCA.

Conclusion

Intraoperative IRE appears to be a feasible and safe method for margin accentuation in advanced iCCA.

Related Resources & Content

1. A Novel Surgical Approach for Intrahepatic Cholangiocarcinoma: The Hilar-First Strategy, 2023 -- Springer
2. Impact of enhanced recovery after surgery (ERAS) on postoperative morbidity and long-term survival in patients with perihilar cholangiocarcinoma, 2026 -- Springer
3. Minimally Invasive Mesohepatectomy for Central Liver Lesions: A Case Series Analysis, 2022 -- Springer
4. Clinical management of intrahepatic cholangiocarcinoma: surgical approaches and systemic therapies, 2024 -- Frontiers
5. Updates in Surgery — Innovative Robotic Approaches to Hepatectomy and Biliary Reconstruction in Perihilar Cholangiocarcinoma: A Groundbreaking Case Series from the West
6. Frontiers | Clinical management of intrahepatic cholangiocarcinoma: surgical approaches and systemic therapies
7. Durvalumab or placebo plus gemcitabine and cisplatin in participants with advanced biliary tract cancer (TOPAZ-1): updated overall survival from a randomised phase 3 study - ScienceDirect