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DOI: 10.1055/s-0039-1681348
EUS-GUIDED, RFA ABLATION OF BENIGN AND MALIGNANT PANCREATIC NEOPLASMS AND EXTRA PANCREATIC METASTASIS IS FEASIBLE AND SAFE
Publikationsverlauf
Publikationsdatum:
18. März 2019 (online)
Aims:
New therapeutic alternatives are needed for patients with pancreatic tumors not suitable for surgery or in order to avoid surgical morbidity. We present our data on the use of a new, through- the-echoendoscope radiofrequency ablation (RFA) device.
Methods:
A 150 cm, 19gauge needle-electrode (EUSRA- Taewoong medical) with RF delivery in the distal 10 mm, connected to a RF generator (VIVA RF STARmed, Korea) settled to deliver 50w was used.
Results:
Since March 2017, 22 patients (median age 63 (28 – 87)) with 36 lesions were treated: seven pancreatic malignant lesions (5 adenocarcinoma), sixteen benign pancreatic lesions (15 neuroendocrine), eight liver metastases, 4 lymph nodes and 1 retroperitoneal metastasis. The pancreatic lesions were located in head, neck, body, tail and uncinate process in 6, 1, 3, 3 and 5 patients. Median size of main lesion was 22 (7 – 55)mm. RFA was performed close to blood vessel or MPD in 7 and 10 times respectively without linked complication except for thrombosis of a small intrahepatic vein and mild delayed pancreatitis in 1 patient each. Other adverse events included: abdominal pain and intrahepatic bile duct stenosis in 2patients each. Median ablation number per lesion was 5 (1 – 16). Imaging showed complete or partial ablation in 15 and 7 patients respectively. After a median follow up of 6 (1 – 21) months no additional related complications were detected.
Conclusions:
EUS-guided RFA of pancreatic tumors and in chosen cases of extrapancreatic metastases is feasible and safe. It represents a promising alternative when surgery is not possible. Larger and longer studies are necessary.
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