Perioperative safety and effect of irreversible electroporation in the management of locally advanced pancreatic carcinoma

Abstract

Objective To evaluate the perioperative safety and effect of irreversible electroporation (IRE) in the treatment of locally advanced pancreatic carcinoma (LAPC). Methods Twenty patients with imaging and cytohystological diagnosis of unresectable locally advanced pancreatic carcinoma were enrolled to undergo IRE treatment. The perioperative IRE-related complications were primarily analyzed to evaluate the safety of the procedure. The tumor reduction and biological response were analyzed through CT/MRI imaging and serous level of CA19-9. Results All patients were successfully treated with an average tumor size of( 4.2±0.6) cm and an average procedure time of (52.0±23.3) minutes. Three intraoperative procedure-related complications were observed (15.0%) including two transient hypertension and one transient superventricular tachycardia. Six postoperative complications were described including two Grade A pancreatic fistula, one infection of incision, one portal vein thrombosis, one gastrointestinal hemorrhage and two functional delayed gastric emptying. The symptom remission rate was 73.7% and lower serum CA19-9 level was recorded in all patients at discharge. Conclusions IRE is a safe and feasible procedure in the treatment of LAPC, and a reasonable operation strategy of IRE is helpful to consolidate the safety and efficacy. Key words: Nanoknife; Irreversible electroporation; Locally advanced pancreatic carcinoma; Ablation; Safe evaluation