Review Article

Endoscopic Ultrasound-Guided Therapies in Pancreatic Neoplasms

Table 2

EUS-guided delivery of ablative energy.

TechniqueReferencesModelOutcomeAdverse events

Goldberg et al. 1999 [26]Swine pancreas13RFA treatment effect (coagulation necrosis and/or fibrosis) seen on pathology on all specimens.Gastric burns () 
Intestinal serosa burn (1) 
Pseudocyst ().
Radiofrequency ablation (RFA)Kim et al. 2012 [27]Swine pancreas10Ablated lesion with surrounding normal pancreatic parenchyma seen on all pathology specimens.None.
Gaidhane et al. 2012 [29]Swine pancreas5RFA treatment effect (coagulative necrosis) in head of pancreas seen only in 1/5.None.

RFA and cryothermal treatmentCarrara et al. 2008 [28]Swine pancreas14RFA treatment effect (coagulation necrosis) in 12/14 animals.Necrotizing pancreatitis (), pancreatitis without symptoms (), gastric burn (), adhesions between pancreas and gut ().

Photodynamic therapy (PDT)Chan et al. 2004 [32]Swine liver, pancreas, kidney, spleen3PDT treatment effect (coagulation necrosis) was 100% in the pancreas (9 applications).Gross ecchymosis on surface of pancreas ().
Yusuf et al. 2008 [33]Swine pancreas6PDT treatment effect (focal fat necrosis) on gross pathology on 6/6 pigs.Elevated serum amylase ().

Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser di Matteo et al. 2010 [35]Swine pancreas8Laser treatment effect (coagulation necrosis) seen in ablated area in all gross specimens.Peripancreatic fluid collection () 
Elevated serum amylase () 
Elevated serum lipase ().

High-intensity focused ultrasound (HIFU)Hwang et al. 2009 [40]Swine pancreas 12HIFU treatment effect only seen at energy 1250 J ().Adhesions of stomach and small intestine (), abdominal wall burns/injury (), gastric antral ulcer (), small bowel adhesions to pancreas ().