To evaluate the efficacy and safety of ultrasound-guided thermal ablation for hepatocellular carcinoma (HCC) adjacent to the second porta hepatis.

Clinical data of 34 patients with HCC near the second porta hepatis who underwent ultrasound-guided thermal ablation in the Third Affiliated Hospital of Sun Yat-sen University from January 2014 to September 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 30 patients were male and 4 female, aged (53±14) years on average. The maximum diameter of lesions was ≤5 cm. Patients were treated with ultrasound-guided percutaneous radiofrequency ablation or microwave ablation. The local tumor progression rate, recurrence rate and incidence of complications were observed.

34 patients (34 lesions) received ablation therapy successfully, including 28 cases of radiofrequency ablation and 6 cases of microwave ablation. 27 lesions were treated with single-needle ablation, and 7 lesions were treated with double-needle ablation. All lesions were evaluated with intraoperative real-time contrast-enhanced ultrasound showing that the ablation zone completely covered the original tumor lesions, and no signs of vascular injury were found. No ablation-related death occurred. Thrombus in the right branch and its subbranches of portal vein were found by ultrasonography on the ^th day after operation, and no special treatment was delivered. The median follow-up time was 19(2-61) months. 1 case was found with residual lesion at postoperative 1 month. The tumor ablation rate was 97%(33/34). 1 case experienced local tumor progression with local tumor progression rate of 3%(1/34) 7 months after operation.

Ultrasound-guided thermal ablation is a safe and efficacious treatment for HCC near the second porta hepatis in suitable cases with reasonable ablation strategies.