Ultrasonic Department, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, People's Republic of China.
Pancreas Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, People's Republic of China.
Jpn J Radiol. 2022 Jan;40(1):86-93. doi: 10.1007/s11604-021-01175-9. Epub 2021 Jul 19.
To evaluate safety and feasibility of laparoscopic ultrasonography (LUS)-guided cryoablation of locally advanced pancreatic cancer (LAPC).
From April 2018 to December 2018, ten patients (five women, five men; mean age 58.2 ± 9.4 years) with LAPC underwent the operation. LUS was used to guide the cryoablation. Computed tomography (CT) imaging, biochemical analysis and pain score analysis by numeric rating scale (NRS) were used to assess treatment outcomes at 1 week and 3 months after the operation.
Cryoablation was performed by the operation in all cases. Seven patients received complete ablation and the success rate of operation was 70%. Two cryoablation cycles and an average of 1.4 ± 0.5 cryoprobes were used. The average freezing time and operation time were 23.8 ± 1.0 and 110.5 ± 24.7 min, respectively. The mean blood loss was 52.0 ± 16.6 ml. No major complications were observed after the operation. The mean maximum tumor diameter determined by CT decreased from 4.9 ± 0.7 cm before the operation to 4.7 ± 1.0 cm at 1 week and 4.6 ± 1.3 cm at 3 months, with P values of 0.53 and 0.51 (relative to the preoperative values), respectively. Postoperative CT imaging results suggested tumor necrosis in cryoablation-treated areas. The mean CA19-9 levels decreased from 347.5 ± 345.7 U/mL before operation to 190.4 ± 153.8 U/mL at 1 week and 182.7 ± 165.6 U/mL at 3 months, with P values of 0.15 and 0.14 (relative to the preoperative values), respectively. The average pain scores declined from 6.9 ± 1.1 before operation to 1.3 ± 1.2 at 1 week and 2.0 ± 0.8 at 3 months, with both P values of < 0.01 (relative to the preoperative values).
This preliminary study suggested that LUS-assisted cryoablation was a safe and feasible treatment for LAPC.
评估腹腔镜超声（LUS）引导下局部进展期胰腺癌（LAPC）冷冻消融的安全性和可行性。
2018 年 4 月至 2018 年 12 月，10 例（5 例女性，5 例男性；平均年龄 58.2±9.4 岁）LAPC 患者接受了手术。LUS 用于引导冷冻消融。术后 1 周和 3 个月采用 CT 成像、生化分析和数字评分量表（NRS）疼痛评分分析评估治疗效果。
所有患者均成功完成了手术中的冷冻消融。7 例患者达到完全消融，手术成功率为 70%。2 例患者接受了 2 个冷冻消融周期，平均使用 1.4±0.5 个冷冻探针。平均冷冻时间和手术时间分别为 23.8±1.0 和 110.5±24.7 分钟。平均失血量为 52.0±16.6ml。术后无严重并发症发生。术后 1 周和 3 个月时，最大肿瘤直径的平均 CT 测量值分别从术前的 4.9±0.7cm 降至 4.7±1.0cm 和 4.6±1.3cm，P 值分别为 0.53 和 0.51（与术前值相比）。术后 CT 影像学结果提示冷冻消融治疗区域肿瘤坏死。术后 1 周和 3 个月时，CA19-9 水平的平均测量值分别从术前的 347.5±345.7U/mL 降至 190.4±153.8U/mL 和 182.7±165.6U/mL，P 值分别为 0.15 和 0.14（与术前值相比）。术后平均疼痛评分从术前的 6.9±1.1 分降至术后 1 周的 1.3±1.2 分和 3 个月的 2.0±0.8 分，P 值均<0.01（与术前值相比）。
初步研究表明，LUS 辅助冷冻消融治疗 LAPC 是一种安全、可行的方法。
