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EUS-guided Radiofrequency Ablation (EUS-RFA) of Solid Pancreatic Neoplasm Using an 18-gauge Needle Electrode: Feasibility, Safety, and Technical Success

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Stefano Francesco Crinò1, Mirko D’Onofrio2, Laura Bernardoni1, Luca Frulloni1, Michele Iannelli2, Giuseppe Malleo3, Salvatore Paiella3, Alberto Larghi4, Armando Gabbrielli1

1) Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona,
2) Department of Radiology, G.B. Rossi University Hospital, Verona,
3) Department of Pancreatic Surgery, The Pancreas Institute, G.B. Rossi University Hospital, Verona,
4) Digestive Endoscopy Unit, Catholic University, Rome, Italy

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.271.eus

Background & Aims:
Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is a promising technique for the treatment of pancreatic neoplasm. We evaluated the feasibility, safety, and technical success of pancreatic EUS-RFA performed in a single center.
Methods: 9 consecutive patients (8 with pancreatic adenocarcinoma and 1 with renal cancer metastasis) were referred for EUS-RFA between November 2016 and July 2017. EUS-RFA was performed using 18-gauge internally cooled electrode with a 5 or 10 mm exposed tip. Feasibility, technical success or early and late adverse events were assessed.
Results: One patient was excluded because of a large necrotic portion. EUS-RFA was feasible in all the other 8 (100%) cases. An ablated area inside the tumor was achieved in all treated patients. No early or late major adverse event was observed after a mean follow-up of 6 months. Three patients experienced mild postprocedural abdominal pain.
Conclusions: EUS-RFA seems a feasible, safe, and effective procedure for pancreatic neoplasms. Its role in the treatment and management of pancreatic masses must be further investigated.
Key words: pancreatic ablation − endoscopic ultrasound − pancreatic cancer − pancreatic adenocarcinoma − radiofrequency ablation.
Abbreviations: CECT: contrast-enhanced computed tomography; EUS: endoscopic ultrasound; EUS-RFA: endoscopic ultrasound-guided radiofrequency ablation; PDAC: pancreatic ductal adenocarcinoma; RFA: radiofrequency ablation