Hepatic Cryotherapy

Hepatic cryotherapy involves the application of material at subzero temperature by multilumen probes positioned intraoperatively under sonographic guidance. This procedure is used to treat nonresectable malignant hepatic tumors. Preanesthetic considerations for hepatic cryotherapy are similar to those for hepatic resection. Heat conservation measures should be instituted during the procedure, with continual monitoring of core temperature. Intraoperative bleeding is rarely significant enough to cause hemodynamic instability. Postoperative pulmonary, renal, and coagulation problems may be manifested as sequelae of the "cryoshock syndrome," even after a procedure with unequivocal intraoperative stability.^[211]