Yan L, Liang B, Feng J, Zhang HY, Chang HS, Liu B, Chen YL. Safety and feasibility of irreversible electroporation for the pancreatic head in a porcine model. World J Gastrointest Oncol 2022; 14(8): 1499-1509 [PMID: 36160734 DOI: 10.4251/wjgo.v14.i8.1499]
Corresponding Author of This Article
Yong-Liang Chen, MD, PhD, Director, Doctor, Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. chenyongl301@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1499-1509 Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1499
Safety and feasibility of irreversible electroporation for the pancreatic head in a porcine model
Li Yan, Bin Liang, Jian Feng, Hang-Yu Zhang, Hao-Sheng Chang, Bing Liu, Yong-Liang Chen
Li Yan, Bin Liang, Hang-Yu Zhang, Hao-Sheng Chang, Bing Liu, Yong-Liang Chen, Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
Jian Feng, Department of Hepatopancreatobiliary Surgery, Peking University Shougang Hospital, Beijing 100144, China
Author contributions: Yan L and Chen YL designed and coordinated the study; Yan L, Liang B, and Feng J performed the experiments, and acquired and analyzed the data; Zhang HY, Chang HS, and Liu B interpreted the data; Yan L and Feng J wrote the manuscript; Liang B and Feng J should be regarded as co-first authors; all authors approved the final version of the article.
Institutional review board statement: The manuscript does not include human experiments.
Institutional animal care and use committee statement: The operational procedures for the animal experiments were approved by the Institutional Animal Care and Use Committee (IACUC) of PLA General Hospital (No. 2016-D12-02).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors have read the ARRIVE Guidelines, and the manuscript was prepared and revised according to the ARRIVE Guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Liang Chen, MD, PhD, Director, Doctor, Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. chenyongl301@163.com
Received: April 6, 2022 Peer-review started: April 6, 2022 First decision: May 10, 2022 Revised: May 12, 2022 Accepted: July 11, 2022 Article in press: July 11, 2022 Published online: August 15, 2022 Processing time: 126 Days and 3.7 Hours
Abstract
BACKGROUND
Irreversible electroporation (IRE) is a local non-thermal ablative technique which has been suggested as a potential cancer therapy. However, the specific anatomic characteristics of the pancreatic head make it challenging to perform any local ablation in this region. Therefore, the safety and feasibility of IRE in the pancreatic head region should be further explored.
AIM
To evaluate the safety of IRE in pancreatic head region including its effects on pancreatic ducts, vessels, and adjacent gastrointestinal organs.
METHODS
Eight landrace miniature pigs underwent IRE of pancreatic head tissue successfully, with a total of 16 lesions created. Laboratory testing including white blood cell (WBC) count and serum amylase before IRE with follow-up laboratory analysis and pathological examination at 1, 7, 14, and 28 d postablation were performed.
RESULTS
All pigs tolerated the ablation procedure without serious perioperative complications. Transiently elevated WBC count and amylase were observed at 24 h post-IRE, suggesting an acute pancreatic tissue damage which was confirmed by pathological observations. Vascular endothelial cells and pancreatic duct epithelial cells in ablation zone were also positive in terminal deoxynucleotidyl transferase dUTP nick end labeling staining. There was extensive duodenum mucosa damage with local hemorrhage 24 h after ablation, while regeneration of new villous structures were observed at 7 and 28 d post-IRE. Masson’s trichromatic staining showed that the extracellular matrix was still intact in vessels and pancreatic ducts, and even in the duodenum.
CONCLUSION
IRE ablation to the pancreatic head may be safe and feasible without long-term damage to the surrounding vital structures. However, risks of stress injuries in acute phase should be taken into consideration to prevent severe perioperative complications.
Core Tip: This is a basic experimental research paper on irreversible electroporation (IRE) in the pancreatic head region. To examine the feasibility and safety of this technique in Landrace pigs, we designed a series of research experiments. We found that IRE ablation to the pancreatic head may be safe and feasible without long-term damage to the surrounding vital structures. However, risks of stress injuries in acute phase should be taken into consideration to prevent severe perioperative complications.
