The experimental study for efficacy and safety of pancreatic cryosurgery.

OBJECTIVE

This study was designed to basic information concerning the efficacy and safety of cryosurgery for pancreatic cancer. Fifteen healthy pigs were used to perform biochemical analysis and histological assessment.

METHODS

Following anesthesia and laparotomy, an argon-helium cryoprobe was inserted into the pancreas. The introduction of argon gas induced a rapid decrease in temperature to -160 degrees C (Group I, 5 pigs) or -110 degrees C (Group II, 5 pigs), respectively, resulting in ice-ball formation of 15-20mm diameter after 5 min. Following freezing, helium gas was circulated in the probe tip to increase the temperature to 10-20 degrees C over 3 min to thaw. The freeze/thaw cycle was then repeated. Group III (3 pigs) had a cryoprobe inserted, but without freezing, and Group IV (2 pigs) included untreated or normal control animals. Levels of serum amylase (AMY), IL-6 and C-RP were measured prior to freezing and for 7 days following the procedure. All pigs were euthanized 7 days post-treatment and pancreases were examined histologically.

RESULTS

Neither hyperaemia, edema or hemorrhage were observed in the un-frozen parts of the pancreas. Histological assessment revealed a significant level of necrosis in the central and lateral regions of the tissue frozen within the ice-ball. All cellular ultrastructure was destroyed and only observable as a few of remaining nuclei with broken crests and degranulated mitochondria and rough endoplasmic reticulum. There was a significant increase of serum AMY levels for a brief period in both "deep frozen" and the "shallow frozen" groups. However, the AMY also increased in two pigs in the "normal control" group and one pig from the "inserted cryoprobe without freeze" control group. All experimental pigs appeared healthy until the sacrifice time.

CONCLUSION

Cryosurgery is a safe and effective ablative procedure for pancreatic tissue resulting in minimal complications.