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Erschienen in: Digestive Diseases and Sciences 4/2017

03.02.2017 | Review

Endoscopic Radiofrequency Ablation of the Pancreas

verfasst von: Tarun Rustagi, Ankit Chhoda

Erschienen in: Digestive Diseases and Sciences | Ausgabe 4/2017

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Abstract

Radiofrequency ablation (RFA) is a well-established technique to ablate dysplastic and neoplastic tissue via local thermal coagulative necrosis. Despite the widespread use in management of several cancers, the application of RFA in pancreas has been limited due to the increased risks of complications from the increased sensitivity of pancreatic tissue to thermal injury and proximity to vascular and biliary structures. RFA has been successfully used during laparotomy for locally advanced pancreatic carcinoma but requires an invasive approach. Endoscopic ultrasound-guided RFA offers the best combination of excellent visualization, real-time imaging guidance, and precise localization with minimal invasiveness. Several animal and human studies have demonstrated the technical feasibility and safety of endoscopic RFA in the pancreas. This article provides a comprehensive review of endoscopic RFA in the management of pancreatic lesions.
Literatur
1.
Zurück zum Zitat McGorisk T, Krishnan K, Keefer L, et al. Radiofrequency ablation for refractory gastric antral vascular ectasia (with video). Gastrointest Endosc. 2013;78:584–588.CrossRefPubMed McGorisk T, Krishnan K, Keefer L, et al. Radiofrequency ablation for refractory gastric antral vascular ectasia (with video). Gastrointest Endosc. 2013;78:584–588.CrossRefPubMed
2.
Zurück zum Zitat Dray X, Repici A, Gonzalez P, et al. 1040 Radiofrequency ablation treatment of gastric antral vascular ectasia: results from an international collaborative study. Gastrointest Endosc. 2013;77:AB180. Dray X, Repici A, Gonzalez P, et al. 1040 Radiofrequency ablation treatment of gastric antral vascular ectasia: results from an international collaborative study. Gastrointest Endosc. 2013;77:AB180.
3.
Zurück zum Zitat Rustagi T, Corbett FS, Mashimo H. Treatment of chronic radiation proctopathy with radiofrequency ablation (with video). Gastrointest Endosc. 2015;81:428–436.CrossRefPubMed Rustagi T, Corbett FS, Mashimo H. Treatment of chronic radiation proctopathy with radiofrequency ablation (with video). Gastrointest Endosc. 2015;81:428–436.CrossRefPubMed
5.
Zurück zum Zitat Sharma VK, Kim HJ, Das A, et al. A prospective pilot trial of ablation of Barrett’s esophagus with low-grade dysplasia using stepwise circumferential and focal ablation (HALO system). Endoscopy. 2008;40:380–387.CrossRefPubMed Sharma VK, Kim HJ, Das A, et al. A prospective pilot trial of ablation of Barrett’s esophagus with low-grade dysplasia using stepwise circumferential and focal ablation (HALO system). Endoscopy. 2008;40:380–387.CrossRefPubMed
6.
Zurück zum Zitat Sharma VK, Wang KK, Overholt BF, et al. Balloon-based, circumferential, endoscopic radiofrequency ablation of Barrett’s esophagus: 1-year follow-up of 100 patients. Gastrointest Endosc. 2007;65:185–195.CrossRefPubMed Sharma VK, Wang KK, Overholt BF, et al. Balloon-based, circumferential, endoscopic radiofrequency ablation of Barrett’s esophagus: 1-year follow-up of 100 patients. Gastrointest Endosc. 2007;65:185–195.CrossRefPubMed
7.
Zurück zum Zitat Shaheen NJ, Overholt BF, Sampliner RE, et al. Durability of radiofrequency ablation in Barrett’s esophagus with dysplasia. Gastroenterology. 2011;141:460–468.CrossRefPubMedPubMedCentral Shaheen NJ, Overholt BF, Sampliner RE, et al. Durability of radiofrequency ablation in Barrett’s esophagus with dysplasia. Gastroenterology. 2011;141:460–468.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Wolf DS, Dunkin BJ, Ertan A. Endoscopic radiofrequency ablation of Barrett’s esophagus. Surg Technol Int. 2012;22:83–89.PubMed Wolf DS, Dunkin BJ, Ertan A. Endoscopic radiofrequency ablation of Barrett’s esophagus. Surg Technol Int. 2012;22:83–89.PubMed
9.
Zurück zum Zitat Lin ZZ, Shau WY, Hsu C, et al. Radiofrequency ablation is superior to ethanol injection in early-stage hepatocellular carcinoma irrespective of tumor size. PLoS ONE. 2013;8:e80276.CrossRefPubMedPubMedCentral Lin ZZ, Shau WY, Hsu C, et al. Radiofrequency ablation is superior to ethanol injection in early-stage hepatocellular carcinoma irrespective of tumor size. PLoS ONE. 2013;8:e80276.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Peng ZW, Liu FR, Ye S, et al. Radiofrequency ablation versus open hepatic resection for elderly patients (>65 years) with very early or early hepatocellular carcinoma. Cancer. 2013;119:3812–3820.CrossRefPubMed Peng ZW, Liu FR, Ye S, et al. Radiofrequency ablation versus open hepatic resection for elderly patients (>65 years) with very early or early hepatocellular carcinoma. Cancer. 2013;119:3812–3820.CrossRefPubMed
11.
Zurück zum Zitat Geyik S, Akhan O, Abbasoglu O, et al. Radiofrequency ablation of unresectable hepatic tumors. Diagn Interv Radiol. 2006;12:195–200.PubMed Geyik S, Akhan O, Abbasoglu O, et al. Radiofrequency ablation of unresectable hepatic tumors. Diagn Interv Radiol. 2006;12:195–200.PubMed
12.
Zurück zum Zitat Zhang YJ, Liang HH, Chen MS, et al. Hepatocellular carcinoma treated with radiofrequency ablation with or without ethanol injection: a prospective randomized trial. Radiology. 2007;244:599–607.CrossRefPubMed Zhang YJ, Liang HH, Chen MS, et al. Hepatocellular carcinoma treated with radiofrequency ablation with or without ethanol injection: a prospective randomized trial. Radiology. 2007;244:599–607.CrossRefPubMed
13.
Zurück zum Zitat Cirocchi R, Trastulli S, Boselli C, et al. Radiofrequency ablation in the treatment of liver metastases from colorectal cancer. Cochrane Database Syst Rev. 2012;6:CD006317. Cirocchi R, Trastulli S, Boselli C, et al. Radiofrequency ablation in the treatment of liver metastases from colorectal cancer. Cochrane Database Syst Rev. 2012;6:CD006317.
14.
Zurück zum Zitat Ruers T, Punt C, Van Coevorden F, et al. Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol. 2012;23:2619–2626.CrossRefPubMedPubMedCentral Ruers T, Punt C, Van Coevorden F, et al. Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol. 2012;23:2619–2626.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Garrean S, Hering J, Saied A, et al. Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature. Am J Surg. 2008;195:508–520.CrossRefPubMed Garrean S, Hering J, Saied A, et al. Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature. Am J Surg. 2008;195:508–520.CrossRefPubMed
16.
Zurück zum Zitat Weng M, Zhang Y, Zhou D, et al. Radiofrequency ablation versus resection for colorectal cancer liver metastases: a meta-analysis. PLoS ONE. 2012;7:e45493.CrossRefPubMedPubMedCentral Weng M, Zhang Y, Zhou D, et al. Radiofrequency ablation versus resection for colorectal cancer liver metastases: a meta-analysis. PLoS ONE. 2012;7:e45493.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Zou YP, Li WM, Zheng F, et al. Intraoperative radiofrequency ablation combined with 125 iodine seed implantation for unresectable pancreatic cancer. World J Gastroenterol. 2010;16:5104–5110.CrossRefPubMedPubMedCentral Zou YP, Li WM, Zheng F, et al. Intraoperative radiofrequency ablation combined with 125 iodine seed implantation for unresectable pancreatic cancer. World J Gastroenterol. 2010;16:5104–5110.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Tang Z, Wu YL, Fang HQ, et al. [Treatment of unresectable pancreatic carcinoma by radiofrequency ablation with ‘cool-tip needle’: report of 18 cases]. Zhonghua Yi Xue Za Zhi. 2008;88:391–394.PubMed Tang Z, Wu YL, Fang HQ, et al. [Treatment of unresectable pancreatic carcinoma by radiofrequency ablation with ‘cool-tip needle’: report of 18 cases]. Zhonghua Yi Xue Za Zhi. 2008;88:391–394.PubMed
19.
Zurück zum Zitat Hadjicostas P, Malakounides N, Varianos C, et al. Radiofrequency ablation in pancreatic cancer. HPB (Oxf). 2006;8:61–64.CrossRef Hadjicostas P, Malakounides N, Varianos C, et al. Radiofrequency ablation in pancreatic cancer. HPB (Oxf). 2006;8:61–64.CrossRef
20.
Zurück zum Zitat Wu Y, Tang Z, Fang H, et al. High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer. J Surg Oncol. 2006;94:392–395.CrossRefPubMed Wu Y, Tang Z, Fang H, et al. High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer. J Surg Oncol. 2006;94:392–395.CrossRefPubMed
21.
Zurück zum Zitat Carrafiello G, Lagana D, Cotta E, et al. Radiofrequency ablation of intrahepatic cholangiocarcinoma: preliminary experience. Cardiovasc Interv Radiol. 2010;33:835–839.CrossRef Carrafiello G, Lagana D, Cotta E, et al. Radiofrequency ablation of intrahepatic cholangiocarcinoma: preliminary experience. Cardiovasc Interv Radiol. 2010;33:835–839.CrossRef
22.
Zurück zum Zitat Chiou YY, Hwang JI, Chou YH, et al. Percutaneous ultrasound-guided radiofrequency ablation of intrahepatic cholangiocarcinoma. Kaohsiung J Med Sci. 2005;21:304–309.CrossRefPubMed Chiou YY, Hwang JI, Chou YH, et al. Percutaneous ultrasound-guided radiofrequency ablation of intrahepatic cholangiocarcinoma. Kaohsiung J Med Sci. 2005;21:304–309.CrossRefPubMed
23.
24.
Zurück zum Zitat Slakey DP. Radiofrequency ablation of recurrent cholangiocarcinoma. Am Surg. 2002;68:395–397.PubMed Slakey DP. Radiofrequency ablation of recurrent cholangiocarcinoma. Am Surg. 2002;68:395–397.PubMed
25.
Zurück zum Zitat Rustagi T, Jamidar PA. Endoscopic treatment of malignant biliary strictures. Curr Gastroenterol Rep. 2015;17:426.PubMed Rustagi T, Jamidar PA. Endoscopic treatment of malignant biliary strictures. Curr Gastroenterol Rep. 2015;17:426.PubMed
27.
Zurück zum Zitat Goldberg SN, Mallery S, Gazelle GS, et al. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model. Gastrointest Endosc. 1999;50:392–401.CrossRefPubMed Goldberg SN, Mallery S, Gazelle GS, et al. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model. Gastrointest Endosc. 1999;50:392–401.CrossRefPubMed
28.
Zurück zum Zitat Kim HJ, Seo DW, Hassanuddin A, et al. EUS-guided radiofrequency ablation of the porcine pancreas. Gastrointest Endosc. 2012;76:1039–1043.CrossRefPubMed Kim HJ, Seo DW, Hassanuddin A, et al. EUS-guided radiofrequency ablation of the porcine pancreas. Gastrointest Endosc. 2012;76:1039–1043.CrossRefPubMed
29.
Zurück zum Zitat Gaidhane M, Smith I, Ellen K, et al. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) of the pancreas in a porcine model. Gastroenterol Res Pract. 2012;2012:431451.CrossRefPubMedPubMedCentral Gaidhane M, Smith I, Ellen K, et al. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) of the pancreas in a porcine model. Gastroenterol Res Pract. 2012;2012:431451.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Silviu UB, Daniel P, Claudiu M, et al. Endoscopic ultrasound-guided radiofrequency ablation of the pancreas: an experimental study with pathological correlation. Endosc Ultrasound. 2015;4:330–335.CrossRefPubMed Silviu UB, Daniel P, Claudiu M, et al. Endoscopic ultrasound-guided radiofrequency ablation of the pancreas: an experimental study with pathological correlation. Endosc Ultrasound. 2015;4:330–335.CrossRefPubMed
31.
Zurück zum Zitat Yoon WJ, Daglilar ES, Kamionek M, et al. Evaluation of radiofrequency ablation using the 1-Fr wire electrode in the porcine pancreas, liver, gallbladder, spleen, kidney, stomach, and lymph nodes: a pilot study. Dig Endosc. 2016;28:465–468.CrossRef Yoon WJ, Daglilar ES, Kamionek M, et al. Evaluation of radiofrequency ablation using the 1-Fr wire electrode in the porcine pancreas, liver, gallbladder, spleen, kidney, stomach, and lymph nodes: a pilot study. Dig Endosc. 2016;28:465–468.CrossRef
32.
Zurück zum Zitat Hines-Peralta A, Hollander CY, Solazzo S, et al. Hybrid radiofrequency and cryoablation device: preliminary results in an animal model. J Vasc Interv Radiol. 2004;15:1111–1120.CrossRefPubMed Hines-Peralta A, Hollander CY, Solazzo S, et al. Hybrid radiofrequency and cryoablation device: preliminary results in an animal model. J Vasc Interv Radiol. 2004;15:1111–1120.CrossRefPubMed
33.
Zurück zum Zitat Carrara S, Arcidiacono P, Albarello L, et al. Endoscopic ultrasound-guided application of a new hybrid cryotherm probe in porcine pancreas: a preliminary study. Endoscopy. 2008;40:321–326.CrossRefPubMed Carrara S, Arcidiacono P, Albarello L, et al. Endoscopic ultrasound-guided application of a new hybrid cryotherm probe in porcine pancreas: a preliminary study. Endoscopy. 2008;40:321–326.CrossRefPubMed
34.
Zurück zum Zitat Petrone MC, Arcidiacono PG, Carrara S, et al. US-guided application of a new hybrid probe in human pancreatic adenocarcinoma: an ex vivo study. Gastrointest Endosc. 2010;71:1294–1297.CrossRefPubMed Petrone MC, Arcidiacono PG, Carrara S, et al. US-guided application of a new hybrid probe in human pancreatic adenocarcinoma: an ex vivo study. Gastrointest Endosc. 2010;71:1294–1297.CrossRefPubMed
35.
Zurück zum Zitat Pai M, Habib N, Senturk H, et al. Endoscopic ultrasound guided radiofrequency ablation, for pancreatic cystic neoplasms and neuroendocrine tumors. World J Gastrointest Surg. 2015;7:52–59.CrossRefPubMedPubMedCentral Pai M, Habib N, Senturk H, et al. Endoscopic ultrasound guided radiofrequency ablation, for pancreatic cystic neoplasms and neuroendocrine tumors. World J Gastrointest Surg. 2015;7:52–59.CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Rossi S, Viera FT, Ghittoni G, et al. Radiofrequency ablation of pancreatic neuroendocrine tumors: a pilot study of feasibility, efficacy, and safety. Pancreas. 2014;43:938–945.CrossRefPubMed Rossi S, Viera FT, Ghittoni G, et al. Radiofrequency ablation of pancreatic neuroendocrine tumors: a pilot study of feasibility, efficacy, and safety. Pancreas. 2014;43:938–945.CrossRefPubMed
37.
Zurück zum Zitat Song TJ, Seo DW, Lakhtakia S, et al. Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer. Gastrointest Endosc. 2015;83:440–443.CrossRefPubMed Song TJ, Seo DW, Lakhtakia S, et al. Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer. Gastrointest Endosc. 2015;83:440–443.CrossRefPubMed
38.
Zurück zum Zitat Lakhtakia S, Ramchandani M, Galasso D, et al. EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos). Gastrointest Endosc. 2015;83:234–239.CrossRefPubMed Lakhtakia S, Ramchandani M, Galasso D, et al. EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos). Gastrointest Endosc. 2015;83:234–239.CrossRefPubMed
39.
Zurück zum Zitat Arcidiacono PG, Carrara S, Reni M, et al. Feasibility and safety of EUS-guided cryothermal ablation in patients with locally advanced pancreatic cancer. Gastrointest Endosc. 2012;76:1142–1151.CrossRefPubMed Arcidiacono PG, Carrara S, Reni M, et al. Feasibility and safety of EUS-guided cryothermal ablation in patients with locally advanced pancreatic cancer. Gastrointest Endosc. 2012;76:1142–1151.CrossRefPubMed
40.
Zurück zum Zitat Date RS, McMahon RF, Siriwardena AK. Radiofrequency ablation of the pancreas. I: definition of optimal thermal kinetic parameters and the effect of simulated portal venous circulation in an ex vivo porcine model. JOP. 2005;6:581–587.PubMed Date RS, McMahon RF, Siriwardena AK. Radiofrequency ablation of the pancreas. I: definition of optimal thermal kinetic parameters and the effect of simulated portal venous circulation in an ex vivo porcine model. JOP. 2005;6:581–587.PubMed
41.
Zurück zum Zitat Date RS, Siriwardena AK. Radiofrequency ablation of the pancreas. II: intra-operative ablation of non-resectable pancreatic cancer. A description of technique and initial outcome. JOP. 2005;6:588–592.PubMed Date RS, Siriwardena AK. Radiofrequency ablation of the pancreas. II: intra-operative ablation of non-resectable pancreatic cancer. A description of technique and initial outcome. JOP. 2005;6:588–592.PubMed
42.
Zurück zum Zitat den Brok MH, Sutmuller RP, van der Voort R, et al. In situ tumor ablation creates an antigen source for the generation of antitumor immunity. Cancer Res. 2004;64:4024–4029.CrossRef den Brok MH, Sutmuller RP, van der Voort R, et al. In situ tumor ablation creates an antigen source for the generation of antitumor immunity. Cancer Res. 2004;64:4024–4029.CrossRef
43.
Zurück zum Zitat Wissniowski TT, Hänsler J, Neureiter D, et al. Activation of tumor-specific T lymphocytes by radio-frequency ablation of the VX2 hepatoma in rabbits. Cancer Res. 2003;63:6496–6500.PubMed Wissniowski TT, Hänsler J, Neureiter D, et al. Activation of tumor-specific T lymphocytes by radio-frequency ablation of the VX2 hepatoma in rabbits. Cancer Res. 2003;63:6496–6500.PubMed
44.
Zurück zum Zitat Cantore M, Girelli R, Mambrini A, et al. Combined modality treatment for patients with locally advanced pancreatic adenocarcinoma. Br J Surg. 2012;99:1083–1088.CrossRefPubMed Cantore M, Girelli R, Mambrini A, et al. Combined modality treatment for patients with locally advanced pancreatic adenocarcinoma. Br J Surg. 2012;99:1083–1088.CrossRefPubMed
45.
Zurück zum Zitat Frigerio I, Girelli R, Giardino A, et al. Short term chemotherapy followed by radiofrequency ablation in stage III pancreatic cancer: results from a single center. J Hepatobiliary Pancreat Sci. 2013;20:574–577.CrossRefPubMed Frigerio I, Girelli R, Giardino A, et al. Short term chemotherapy followed by radiofrequency ablation in stage III pancreatic cancer: results from a single center. J Hepatobiliary Pancreat Sci. 2013;20:574–577.CrossRefPubMed
46.
Zurück zum Zitat Rustagi T, Gleeson FC, AbuDayyeh BK, Topazian MD, Levy MJ. Evaluation of effects of radiofrequency ablation of ex vivo liver using the 1-Fr wire electrode. J Clin Gastroenterol. 2017. doi:10.1007/s10620-017-4452-y. Rustagi T, Gleeson FC, AbuDayyeh BK, Topazian MD, Levy MJ. Evaluation of effects of radiofrequency ablation of ex vivo liver using the 1-Fr wire electrode. J Clin Gastroenterol. 2017. doi:10.​1007/​s10620-017-4452-y.
47.
Zurück zum Zitat Hirota M, Kimura Y, Ishiko T, et al. Visualization of the heterogeneous internal structure of so-called “pancreatic necrosis” by magnetic resonance imaging in acute necrotizing pancreatitis. Pancreas. 2002;25:63–67.CrossRefPubMed Hirota M, Kimura Y, Ishiko T, et al. Visualization of the heterogeneous internal structure of so-called “pancreatic necrosis” by magnetic resonance imaging in acute necrotizing pancreatitis. Pancreas. 2002;25:63–67.CrossRefPubMed
49.
Zurück zum Zitat Matsui Y, Nakagawa A, Kamiyama Y, et al. Selective thermocoagulation of unresectable pancreatic cancers by using radiofrequency capacitive heating. Pancreas. 2000;20:14–20.CrossRefPubMed Matsui Y, Nakagawa A, Kamiyama Y, et al. Selective thermocoagulation of unresectable pancreatic cancers by using radiofrequency capacitive heating. Pancreas. 2000;20:14–20.CrossRefPubMed
50.
Zurück zum Zitat Elias D, Baton O, Sideris L, Lasser P, Pocard M. Necrotizing pancreatitis after radifrequency destruction of pancreatic tumors. Eur J Surg Oncol. 2004;30:85–87.CrossRefPubMed Elias D, Baton O, Sideris L, Lasser P, Pocard M. Necrotizing pancreatitis after radifrequency destruction of pancreatic tumors. Eur J Surg Oncol. 2004;30:85–87.CrossRefPubMed
51.
Zurück zum Zitat Varshney S, Sewkani A, Sharma S, et al. Radiofrequency ablation of unresectable pancreatic carcinoma: feasibility, efficacy and safety. JOP. 2006;7:74–78.PubMed Varshney S, Sewkani A, Sharma S, et al. Radiofrequency ablation of unresectable pancreatic carcinoma: feasibility, efficacy and safety. JOP. 2006;7:74–78.PubMed
Metadaten
Titel
Endoscopic Radiofrequency Ablation of the Pancreas
verfasst von
Tarun Rustagi
Ankit Chhoda
Publikationsdatum
03.02.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 4/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4452-y

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