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...

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Autores: Ielpo, Benedetto, Pueyo Périz, Eva M., Radosevic, Aleksandar, 1974-, Andaluz, Anna, Berjano, Enrique J., Grande Posa, Luís, Sánchez Velázquez, Patricia, 1985-, Burdío Pinilla, Fernando
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/48490
Acceso en línea:http://hdl.handle.net/10230/48490
http://dx.doi.org/10.1080/02656736.2021.1917703
Access Level:acceso abierto
Palabra clave:Endoluminal ablation
Pancreatic duct
Pancreatic fistula
Pancreaticoduodenectomy
Thermal ablation
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spelling Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomyIelpo, BenedettoPueyo Périz, Eva M.Radosevic, Aleksandar, 1974-Andaluz, AnnaBerjano, Enrique J.Grande Posa, LuísSánchez Velázquez, Patricia, 1985-Burdío Pinilla, FernandoEndoluminal ablationPancreatic ductPancreatic fistulaPancreaticoduodenectomyThermal ablationPurpose: 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.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.Taylor & Francis202120212021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/48490http://dx.doi.org/10.1080/02656736.2021.1917703reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésInt J Hyperthermia. 2021;38(1):755-9info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C21info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C22© 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.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/484902026-06-12T07:21:37Z
dc.title.none.fl_str_mv Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
title Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
spellingShingle Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
Ielpo, Benedetto
Endoluminal ablation
Pancreatic duct
Pancreatic fistula
Pancreaticoduodenectomy
Thermal ablation
title_short 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_sort Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy
dc.creator.none.fl_str_mv Ielpo, Benedetto
Pueyo Périz, Eva M.
Radosevic, Aleksandar, 1974-
Andaluz, Anna
Berjano, Enrique J.
Grande Posa, Luís
Sánchez Velázquez, Patricia, 1985-
Burdío Pinilla, Fernando
author Ielpo, Benedetto
author_facet Ielpo, Benedetto
Pueyo Périz, Eva M.
Radosevic, Aleksandar, 1974-
Andaluz, Anna
Berjano, Enrique J.
Grande Posa, Luís
Sánchez Velázquez, Patricia, 1985-
Burdío Pinilla, Fernando
author_role author
author2 Pueyo Périz, Eva M.
Radosevic, Aleksandar, 1974-
Andaluz, Anna
Berjano, Enrique J.
Grande Posa, Luís
Sánchez Velázquez, Patricia, 1985-
Burdío Pinilla, Fernando
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Endoluminal ablation
Pancreatic duct
Pancreatic fistula
Pancreaticoduodenectomy
Thermal ablation
topic Endoluminal ablation
Pancreatic duct
Pancreatic fistula
Pancreaticoduodenectomy
Thermal ablation
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.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/48490
http://dx.doi.org/10.1080/02656736.2021.1917703
url http://hdl.handle.net/10230/48490
http://dx.doi.org/10.1080/02656736.2021.1917703
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Int J Hyperthermia. 2021;38(1):755-9
info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C21
info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C22
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Taylor & Francis
publisher.none.fl_str_mv Taylor & Francis
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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