High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer

J Surg Oncol. 2006 Oct 1;94(5):392-5. doi: 10.1002/jso.20580.

Abstract

Background and objectives: To report and discuss the effect, complications and mortality of cool-tip radiofrequency ablation (RFA) for unresectable pancreatic cancer.

Methods: During October 2003 to July 2004, sixteen patients with unresectable pancreatic cancer were treated by open cool-tip RFA. One-half of the 16 patients had tumors located in the pancreatic head. A 5-mm minimum safe distance between RFA site and major peripancreatic vessels was kept to avoid injury to the vessels.

Results: Six of twelve patients with back pain got pain relief postoperatively. Pancreatic fistula occurred in three patients (18.8%) and healed smoothly in 7-10 days with routine abdominal drainage. The mortality was 25% (4/16). In the four death cases, tumors were all located in the pancreatic head; three patients with tumor close to portal vein died suddenly of massive gastrointestinal hemorrhage on the 4th, 30th, 40th postoperative day respectively and a 79-year-old patient died of acute renal failure on the 2nd postoperative day.

Conclusions: Standard use of cool-tip RFA was dangerous for pancreatic head cancer close to portal vein, in which a 5-mm minimum safe distance between RFA site and major peripancreatic vessels might not be enough to avoid injury to the vessels.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / etiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Back Pain / etiology
  • Catheter Ablation / adverse effects*
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Fistula / etiology
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / mortality*
  • Risk