Abstract
Objective
To determine the short-term outcome of radiofrequency ablation (RFA) of pancreatic
tissue near the duodenum and portomesenteric vessels (PMV) in a porcine model with
and without intraluminal duodenal cooling.
Background
RFA has been proposed as a new treatment strategy in patients with unresectable locally
advanced pancreatic cancer. RFA may cause thermal damage to the duodenum and vascular
structures, but these risks and potential protective measures have never been systematically
addressed. Intraluminal duodenal cooling during RFA could prevent thermal damage to
the duodenum.
Methods
RFA was performed in 11 pigs during laparotomy with a bipolar probe of 30 mm active
length at a power of 30 W until a total energy of 15 kJ was administered. The RFA
probe was inserted in the pancreas at 5 or 15 mm from the duodenum, PMV, and in the
pancreatic tail. RFA near the duodenum was performed with and without intraluminal
duodenal cooling using 100 mL/min saline of 5°C. Histopathologic assessment was performed.
Results
The maximum RFA-induced temperature was 92°C. RFA with one single probe induced adequate
ablation lesions with a diameter of 20 mm over a length of 30 mm. Without duodenal
cooling, RFA induced duodenal thermal damage, whereas with duodenal cooling, no damage
was observed. RFA at 15 mm from the PMV resulted in minimal superficial focal vascular
damage, without thrombosis or hemorrhage.
Conclusions
RFA provides adequate ablation zones in the pancreas of the porcine. Thermal damage
to the duodenum can be prevented by intraluminal duodenal cooling without loss of
ablation effectivity.
Keywords
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Article info
Publication history
Published online: May 22, 2013
Accepted:
April 26,
2013
Received in revised form:
April 21,
2013
Received:
March 21,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
