Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy

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• dc.contributor.author Ielpo, Benedetto
• dc.contributor.author Pueyo Périz, Eva M.
• dc.contributor.author Radosevic, Aleksandar, 1974-
• dc.contributor.author Andaluz, Anna
• dc.contributor.author Berjano, Enrique J.
• dc.contributor.author Grande Posa, Luís
• dc.contributor.author Sánchez Velázquez, Patricia, 1985-
• dc.contributor.author Burdío Pinilla, Fernando
• dc.date.accessioned 2021-09-22T06:34:52Z
• dc.date.available 2021-09-22T06:34:52Z
• dc.date.issued 2021
• dc.description.abstract Purpose: Multiple attempts have been made to manage the pancreatic stump and the pancreatic duct in order to reduce the rate of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD), however radiofrequency-based technologies could help to achieve this goal. Previous encouraging clinical and experimental results support the use of endoluminal thermal ablation (ETHA) of the main pancreatic duct to reduce pancreatic exocrine secretion and hence POPF. We here describe our initial clinical experience with ETHA of the main pancreatic duct in two cases at high risk of POPF. Methods: Two cases underwent PD for malignancy with a high risk of POPF (adenocarcinoma, obese patients, surgical difficulties with heavy intraoperative blood loss, soft pancreas or walled-off pancreatitis and a tight small pancreatic main duct). In both cases, ETHA of the main pancreatic duct was conducted intraoperatively just before Blumgart-type pancreatic-jejunal anastomosis using a ClosureFast catheter (Medtronic, Mansfield, MA, USA) normally used for varicose vein treatment (therefore an off-label use). Results: Although a clear radiological POPF was detected in the second case, the clinical postoperative course in both cases was uneventful. Little pancreatic fluid collected in the abdominal drainage with low levels of amylase enzyme, confirming low exocrine pancreatic function. No other procedure-related complications were detected. Conclusion: Endoluminal thermal ablation of the main pancreatic duct may be a feasible and safe technique to reduce the adverse effects of POPF after PD.
• dc.description.sponsorship This work was supported by the Spanish Ministerio de Ciencia, Innovación y Universidades under “Programa Estatal de I + D + i Orientada a los Retos de la Sociedad”, Grants RTI2018-094357-B-C21 and RTI2018-094357-B-C22.
• dc.format.mimetype application/pdf
• dc.identifier.citation Ielpo B, Pueyo-Périz EM, Radosevic A, Andaluz A, Berjano E, Grande L, Sánchez-Velázquez P, Burdío F. Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy. Int J Hyperthermia. 2021;38(1):755-9. DOI: 10.1080/02656736.2021.1917703
• dc.identifier.doi http://dx.doi.org/10.1080/02656736.2021.1917703
• dc.identifier.issn 0265-6736
• dc.identifier.uri http://hdl.handle.net/10230/48490
• dc.language.iso eng
• dc.publisher Taylor & Francis
• dc.relation.ispartof Int J Hyperthermia. 2021;38(1):755-9
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C21
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C22
• dc.rights © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Endoluminal ablation
• dc.subject.keyword Pancreatic duct
• dc.subject.keyword Pancreatic fistula
• dc.subject.keyword Pancreaticoduodenectomy
• dc.subject.keyword Thermal ablation
• dc.title Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion