Endoscopy 2009; 41(7): 598-602
DOI: 10.1055/s-0029-1214823
Original article

© Georg Thieme Verlag KG Stuttgart · New York

A pilot study of EUS-guided hot saline injection for induction of pancreatic tissue necrosis

H.  Imazu1 , K.  Sumiyama1 , K.  Ikeda1 , Y.  Uchiyama1 , H.  Aihara1 , H.  Kakutani1 , M.  Kaise1 , T.  L.  Ang2 , S.  Omar3 , H.  Tajiri4
  • 1Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
  • 2Division of Gastroenterology, Department of Medicine, Changi General Hospital, Singapore
  • 3Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 4Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University, Tokyo, Japan
Further Information

Publication History

submitted22 September 2008

accepted after revision11 March 2009

Publication Date:
08 July 2009 (online)

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Commentaire de travail de H. Imazu et al., pp. 598Endoscopy 2009; 41(07): 737-738
DOI: 10.1055/s-0032-1306740

Background and study aims: Hot saline may be potentially useful for inducing necrosis of pancreatic tissue. However, the local and systemic effects are largely unknown. This pilot study aimed to evaluate the feasibility and safety of EUS-guided injection of hot saline into the pancreas in the porcine model.

Methods: Boiling hot saline was injected into the tail of normal porcine pancreas under EUS guidance in six pigs via a transgastric approach. Three pigs were killed 4 hours later to study the acute effect of the hot saline injection (acute study). The remaining three pigs were killed after 7 days of clinical observation (survival study).

Result: Injection of 5 mL, 2 mL and 1 mL of hot saline produced localized necrosis (7 – 10 mm) of pancreatic tissue in the acute study. However, there was pooling of hot saline on the surface of the pancreas when 5mL was injected. On the basis of the results of the acute study, the volume of hot saline injected in the survival study was 1 mL. One milliliter of hot saline produced localized or sporadic necrosis of pancreatic tissue without any signs of pancreatitis in all three pigs in the survival study; hot saline was observed to pool on the pancreatic surface of one pig. There was no histological evidence of necrosis in the pancreatic tissue adjacent to the pooled hot saline in either the acute or the survival study.

Conclusion: EUS-guided hot saline injection of pancreatic tissue in the porcine model was technically successful and led to localized necrosis of pancreatic tissue without any sign of pancreatitis.

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H. ImazuMD, PhD 

Department of Endoscopy
Jikei University School of Medicine

3-25-8 Nishi-shinbashi
Minato-ku
Tokyo
Japan 105-8461

Fax: +81-3-3459-4524

Email: himazu21@aol.com