Endoscopy 2008; 40(4): 321-326
DOI: 10.1055/s-2007-995595
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided application of a new hybrid cryotherm probe in porcine pancreas: a preliminary study

S.  Carrara1 , P.  G.  Arcidiacono1 , L.  Albarello2 , A.  Addis3 , M.  D.  Enderle4 , C.  Boemo1 , M.  Campagnol3 , A.  Ambrosi5 , C.  Doglioni2 , P.  A.  Testoni1
  • 1Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy
  • 2Department of Pathology, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy
  • 3CRABCC (Research Center on Biotechnological Applications in Cardiovascular Surgery) University of Milan, Italy
  • 4ERBE Elektromedizin GmbH, Tübingen, Germany
  • 5CUSSB University Centre of Statistics for Biomedical Sciences, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy
Further Information

Publication History

submitted 19 September 2007

accepted after revision 16 November 2007

Publication Date:
04 April 2008 (online)

Background and study aims: Open, laparoscopic, or percutaneous radiofrequency (RF) ablation of the pancreas is still dangerous, whereas endoscopic ultrasound (EUS)-guided ablation might reduce risk because it is less invasive and provides real-time monitoring. We aimed to demonstrate the feasibility of transluminal RF ablation and to evaluate the efficacy and safety of a new flexible bipolar ablation probe combining RF and cryotechnology.

Methods: 14 ablations were performed in 14 pigs. Energy input (16 W) and simultaneous cryogenic cooling with carbon dioxide (650 psi) were standardized. Application time range was 120 - 900 seconds. Ablation area was measured by EUS immediately after ablation (area T0), and before euthanasia (area T1). Macroscopic findings (area T2) and histological findings after necropsy served as gold standard. The interval from application to euthanasia was either 1 or 2 weeks.

Results: The correlation between EUS findings (area T1) and macroscopic appearance (area T2) was good (R = 0.89). The correlation between the T2 ablation area and the application time showed a fitted ratio of 2.3 (P < 0.0001) with a 1-week interval and 0.2 (P = 0.01) with a 2-week interval. No pig died because of the procedure. Two pigs showed histochemical pancreatitis, which was clinically overt in one. Necropsy additionally revealed one burn to the gastric wall and four gut adhesions.

Conclusions: Selective transluminal RF ablation of the pancreas under EUS control in a living pig model is feasible. The new flexible bipolar probe creates an ablation area with extent related to the duration of application, and with fewer complications than conventional RF ablation techniques.

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P. G. Arcidiacono, MD

Vita-Salute San Raffaele University

Via Olgettina no. 60

20132 Milan

Italy

Fax: +39-2-26432504

Email: arcidiacono.paologiorgio@hsr.it