CT-guided percutaneous irreversible electroporation of locally advanced pancreatic cancer: a complications analysis

Abstract

Objective To investigate the CT-guided percutaneous irreversible electroporation (IRE) in treating locally advanced pancreatic cancer (LAPC) and providing guidance for its prevention and treatment. Methods We retrospectively analyzed the clinical and imaging data of 17 patients (17 lesions) of LAPC treated with CT-guided IRE in our hospital from July 2015 to June 2016. Complications were documented and reviewed at day 7, 30 and 90 follow up as well as during the procedure. The Clavien-Dindo was used for classification. The reasons that induced complications were summarized and to further discuss the prevention and treatment approaches. Results Of 17 patients, 2 patients suffered a transient tachycardia during the procedure. Eleven patients (65%) showed complications at day 7, of which grade Ⅰ complications occurred in 6 cases, including abdominal pain, nausea, vomiting, or a few of inflammatory exudations around the pancreas; four patients have grade Ⅱ complications, along with portal vein thrombosis;one patient showed grade Ⅲa complications for retroperitoneal infection. With 30 days follow up, the grade Ⅰ complications disappeared, grade Ⅱ complications have not getting better, while grade Ⅲa complications have been improved. With 90 days follow up, patients with grade Ⅲ a complications getting better;two patients with grade Ⅱ complications didn't show any changes; 2 cases progressed to grade Ⅴ, and died of digestive tract bleeding at 82 days and 98 days after procedure. Conclusion CT-guided irreversible electroporation for treating LAPC is a safe ablation approach. Strict patient selection before procedure and make a reasonable prevention and treatment measures can reduce the complications. Key words: Pancreatic neoplasms; Ablation techniques; Irreversible electroporation; Radiology, interventional