Radiofrequency ablation of pancreas and optimal cooling of peripancreatic tissue in an ex-vivo porcine model

Radiofrequency ablation is a possible palliative treatment for patients suffering from pancreatic neoplasia. However, radiofrequency-induced damage to the peripancreatic tissues during pancreatic ablation might cause fatal complications. The aim of this experimental ex vivo study on pigs was to verify ablation protocols and evaluate whether or not the cooling of peripancereatic tissues during pancreatic ablation has any benefit for their protection against thermal injury. Radiofrequency ablation was performed on 52 pancreatic specimens obtained from pigs. During each pancreatic ablation, continuous measurements of the temperature in the portal vein and duodenal lumen were performed. Peripancreatic tissues were either not cooled or were cooled by being submerged in 14 degrees C water, or by a perfusion of the portal vein and duodenum with 14 degrees C saline. The effects of variation in target temperature of the ablated area (90 degrees C and 100 degrees C), duration of ablation (5 and 10 min) and the effect of peripancreatic tissues cooling were studied. We proved that optimal radiofrequency ablation of the porcine pancreas can be reached with the temperature of 90 degrees C for 5 min in the ablated area. The perfusion of the duodenal and portal vein by 14 degrees C saline was found to be the most effective cooling method for minimizing damage to the walls. Continuous measurement of temperatures in peripancreatic tissues will provide useful feedback to assist in their protection against thermal injury. This therapy could be used in the treatment of pancreatic tumours.