Endoscopic electrolytic ablation : feasibility and safety in the treatment of pancreatic pathologies
thesisposted on 15.12.2014, 10:31 by Charles Paul Morrison
Pancreatic cancer has a dismal prognosis. It is a condition that tends to present late meaning that the majority of patients are only suitable for palliative therapy. This research aims to assess the feasibility and safety of using electrolysis, a locally ablative technique, as a potential tool in the treatment of pancreatic cancer and other pancreatic mass lesions either independently or as an adjunct to other modalities. Experimental work investigated the use of pancreatic electrolytic ablation, both open and endoscopic, in a porcine model. Phase 1a: short term follow-up open pancreatic electrolysis. Twelve female white domestic pigs underwent laporotomy, duodenotomy and open pancreatic duct cannulation. Six received pancreatic electrolysis, six were used as controls. All animals were followed up for 72 hours and then killed. Phase 1b: medium and long term follow up open pancreatic electrolysis. Eight female white domestic pigs underwent open pancreatic electrolytic ablation. Four animals were killed at two weeks, the remaining at eight weeks. Phase 2: medium and long term follow up endoscopic pancreatic electrolysis. Fifteen female white domestic pigs all had endoscopic pancreatic duct cannulation. Ten pigs underwent endoscopic pancreatic electrolytic ablation and the other five pigs were used as controls. Five treatment animals and the five control animals were killed at two weeks, the remaining five animals at eight weeks. All animals tolerated the procedure and had returned to normal diet by day three. There were no significant (p>0.05) differences between the treatment and control groups with respect to biochemical parameters or cytokine concentrations by the end of the study period. Histological assessment of pancreata demonstrated significantly (p<0.05) increased inflammatory changes in all the treatment groups when compared with controls.