Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
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 c...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | International Journal of Hyperthermia |
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| Online Access: | http://dx.doi.org/10.1080/02656736.2021.1917703 |
| _version_ | 1819096808244117504 |
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| author | Benedetto Ielpo Eva M. Pueyo-Périz Aleksandar Radosevic Anna Andaluz Enrique Berjano Luis Grande Patricia Sánchez-Velázquez Fernando Burdío |
| author_facet | Benedetto Ielpo Eva M. Pueyo-Périz Aleksandar Radosevic Anna Andaluz Enrique Berjano Luis Grande Patricia Sánchez-Velázquez Fernando Burdío |
| author_sort | Benedetto Ielpo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T00:05:05Z |
| format | Article |
| id | doaj.art-f5162385d02c411bacef84a53c6301f8 |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-12-22T00:05:05Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-f5162385d02c411bacef84a53c6301f82022-12-21T18:45:35ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572021-01-0138175575910.1080/02656736.2021.19177031917703Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomyBenedetto Ielpo0Eva M. Pueyo-Périz1Aleksandar Radosevic2Anna Andaluz3Enrique Berjano4Luis Grande5Patricia Sánchez-Velázquez6Fernando Burdío7Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University Hospital del Mar-IMIM (Hospital del Mar Medical Research Institute)Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University Hospital del Mar-IMIM (Hospital del Mar Medical Research Institute)Department of Radiology, Hospital del MarDepartament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de BarcelonaBioMIT, Department of Electronic Engineering, Universitat Politècnica de ValènciaDivision of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University Hospital del Mar-IMIM (Hospital del Mar Medical Research Institute)Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University Hospital del Mar-IMIM (Hospital del Mar Medical Research Institute)Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University Hospital del Mar-IMIM (Hospital del Mar Medical Research Institute)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.http://dx.doi.org/10.1080/02656736.2021.1917703endoluminal ablationpancreatic ductpancreatic fistulapancreaticoduodenectomythermal ablation |
| spellingShingle | Benedetto Ielpo Eva M. Pueyo-Périz Aleksandar Radosevic Anna Andaluz Enrique Berjano Luis Grande Patricia Sánchez-Velázquez Fernando Burdío Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy International Journal of Hyperthermia endoluminal ablation pancreatic duct pancreatic fistula pancreaticoduodenectomy thermal ablation |
| title | Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy |
| title_full | Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy |
| title_fullStr | Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy |
| title_full_unstemmed | Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy |
| title_short | Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy |
| title_sort | clinical case report endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy |
| topic | endoluminal ablation pancreatic duct pancreatic fistula pancreaticoduodenectomy thermal ablation |
| url | http://dx.doi.org/10.1080/02656736.2021.1917703 |
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