Geranios Angelos, Pikoulis Emmanouil, Papalois Apostolos, Kontos Michael, Agrogiannis George, Petrou Athanasios, Pavlakis Emmanuel, Felekouras Evangelos
Department of Surgery, Konstantopouleion General Hospital, Athens, Greece.
Am Surg. 2015 May;81(5):483-91.
Pancreatic carcinoma is one of the commonest malignant diseases today and the majority of patients are suitable for palliative treatment only. Radiofrequency ablation (RFA) has been used extensively for the treatment of solid organ tumors but little is known on the efficacy and safety of pancreatic ablation. To further investigate the safety of pancreatic RFA, 18 pigs had RFA of the pancreas, close to superior mesenteric vein and duodenum. Group A (nine animals) was protected with peripancreatic cool perfusion and Group B (nine animals) with portal vein (PV) intravenous injection of cool saline. Biochemical and histological evidence suggested lateral thermal injury of the duodenal wall and superior mesenteric vein and acute pancreatitis in most animals. However, clinically and at autopsy, Group B animals fared much better. PV thrombosis, hepatic abscess, duodenal perforation, ascites, and extensive pancreatic necrosis were observed in Group A but not in Group B. The present study suggests that PV cool saline perfusion can prevent major complications caused by pancreatic RFA and may be used in combination with other protective techniques in the clinical setting to reduce RFA-associated morbidity.
胰腺癌是当今最常见的恶性疾病之一，大多数患者仅适合姑息治疗。射频消融（RFA）已广泛用于实体器官肿瘤的治疗，但关于胰腺消融的疗效和安全性知之甚少。为进一步研究胰腺RFA的安全性，对18头猪的胰腺进行RFA，靠近肠系膜上静脉和十二指肠。A组（9只动物）采用胰腺周围冷灌注保护，B组（9只动物）采用门静脉（PV）静脉注射冷盐水。生化和组织学证据表明，大多数动物的十二指肠壁和肠系膜上静脉存在侧向热损伤以及急性胰腺炎。然而，在临床和尸检中，B组动物的情况要好得多。A组观察到PV血栓形成、肝脓肿、十二指肠穿孔、腹水和广泛的胰腺坏死，而B组未观察到。本研究表明，PV冷盐水灌注可预防胰腺RFA引起的主要并发症，并可在临床环境中与其他保护技术联合使用，以降低RFA相关的发病率。
