Irreversible electroporation of the pancreas: Definitive local therapy without systemic effects

BACKGROUND: The use of thermal tumor ablative techniques in the pancreas is limited due to the risk of pancreatitis and damage to major vascular structures. Irreversible electroporation (IRE) is a non-thermal ablation technique that could allow ablation in the pancreas while preserving vital surrounding blood vessels. The aim of this study was to assess the safety and ablation volume of IRE in porcine pancreatic tissue. METHODS: IRE of swine pancreases was performed using an open technique and ultrasound guidance and the animals were followed for 72 hr, 7 days, and 14 days post-IRE. RESULTS: All pigs underwent IRE, with one pig was unsuccessful after three attempts using at 3,000 V due to inability to achieve a stable current. All animals recovered well and revealed only mild adhesions, no ascites, and no pancreatic necrosis. All animals had transient increases in amylase and lipase that normalized on post-IRE day 3. Pathologic analysis revealed that ablation defects (median size 3 cm × 2.8 cm) were seen in electroporated areas with significant destruction of the pancreatic tissue with patent vascular structures. CONCLUSIONS: This animal model demonstrates that IRE of the pancreas performed at an optimal voltage is well tolerated, with rapid resolution of pancreatic inflammation and preservation of vascular structures.