title: Cryoablation of unresectable pancreatic cancer.
abstract: BACKGROUND
  Most patients with pancreatic cancer are not candidates for curative resection. The goal of this study was to evaluate the safety of an intraoperative ultrasound-guided cryosurgical procedure in a phase I study of unresectable pancreatic cancer.
  
  
  METHODS
  From March 1995 to March 1999, 10 cryosurgeries using intraoperative ultrasound were performed on 9 patients with unresectable cancers at laparotomy. Four patients had a concurrent gastrojejunostomy, 2 had a chemical splanchnicectomy, and 1 underwent a concurrent hepatic cryosurgical procedure.
  
  
  RESULTS
  There was no intraoperative morbidity or mortality. No patients developed postoperative pancreatitis or fistula. All patients had good pain control postoperatively and were tolerating a regular diet at the time of discharge. Pain control at discharge was achieved with an oral formulation (4/9), transdermal patch (3/9), no pain medication (1/9), and intravenous patient controlled analgesia (1/9).
  
  
  CONCLUSIONS
  Ultrasound-guided cryoablation for unresectable pancreatic cancer appears safe and may contribute to improved postoperative pain control. Future studies to determine its therapeutic role in the management of unresectable pancreatic cancer are indicated.
authors.affiliation: Department of Surgery, University of Rochester Medical Center, Box SURG, 601 Elmwood Avenue, Rochester, NY 14642, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kovach
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hendrickson
authors.forename: Charles R
authors.initials: CR
authors.lastname: Cappadona
authors.forename: C Max
authors.initials: CM
authors.lastname: Schmidt
authors.forename: Kara
authors.initials: K
authors.lastname: Groen
authors.forename: Leonidas G
authors.initials: LG
authors.lastname: Koniaris
authors.forename: James V
authors.initials: JV
authors.lastname: Sitzmann
mesh_terms: D003452:Cryosurgery / Q000379:methods; D003714:Denervation; D005774:Gastrostomy; D006801:Humans; D007432:Intraoperative Period; D007582:Jejunostomy; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011182:Postoperative Care; D011446:Prospective Studies; D013153:Splanchnic Nerves; D016896:Treatment Outcome; D014463:Ultrasonography