Korean J Hepatobiliary Pancreat Surg.  2016 Aug;20(3):116-120. 10.14701/kjhbps.2016.20.3.116.

Irreversible electroporation for the treatment of pancreatic neuroendocrine tumors

• Papamichail M
• Ali A
• Pizanias M
• Peddu P
• Karani J
• Heaton N

• KMID: 2351298
• DOI: http://doi.org/10.14701/kjhbps.2016.20.3.116

Abstract

BACKGROUNDS/AIMS
Resection or enucleation is currently the treatment of choice for small pancreatic neuroendocrine tumors (NETs). Irreversible electroporation is a novel ablative method that is used for locally advanced pancreatic adenocarcinoma, but little data exists for its use for pancreatic NETs. We report an early experience of IRE for early pancreatic NETs.
METHODS
Between April 2014 and March 2015, 3 patients with small (<2 cm) pancreatic NETs were treated with percutaneous IRE.
RESULTS
There were no adverse effects during the procedure. Mean hospital stay was 2.6 days. All patients remained disease free on 12-19 months follow up. One patient developed recurrent pancreatitis with pseudocyst formation.
CONCLUSIONS
IRE for small tumors of the pancreas is practical and may offer advantages over other thermal ablative techniques, since it preserves vital structures such as blood vessels, bile and pancreatic ducts. Further data regarding the long term disease free interval is required to establish efficacy.

Keyword

Irreversible electroporation (IRE); Pancreatic neuroendocrine tumors; Non-thermal ablation

MeSH Terms

Adenocarcinoma
Bile
Blood Vessels
Electroporation*
Follow-Up Studies
Humans
Length of Stay
Methods
Neuroendocrine Tumors*
Pancreas
Pancreatic Ducts
Pancreatitis

Figure

• 

  Fig. 1 Computed tomography (CT) scan showing a small hypervascular lesion at the head of the pancreas (arrow) consistent with neuroendocrine tumor (A). Irreversible electroporation (IRE) was performed using two electrodes placed percutaneously (B). CT scan 2 days post-IRE showed successful ablation (C). Three-month post-ablation CT scan showed no recurrence (D).

• 

  Fig. 2 Computed tomography and magnetic resonance imaging showing a large-sized (13 cm) pancreatic pseudocyst following recurrent post-IRE pancreatitis (A) with significant resolution (reduced to 3 cm) 4 months later (B).

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