title: Palliation of pancreatic cancer using electrolytic ablation.
abstract: BACKGROUND
  Inoperable pancreatic cancer has a dismal prognosis. Palliation involves either stenting or surgical bypass. Stenting does not relieve gastric outlet obstruction, and surgical bypass is a major procedure. A minimally invasive procedure is needed that relieves both gastric outlet and biliary obstruction, with the potential for relieving pain.
  
  
  METHODS
  In an experimental model, pancreatic electrolysis was investigated. The pancreatic duct was cannulated via a transduodenal approach with an electrode catheter. In 6 animals an electrolytic "lesion" was created using a direct current generator. Six animals were controls. The local and systemic effects of electrolysis were assessed using histological and biochemical parameters.
  
  
  RESULTS
  The pancreatic duct was cannulated in all animals and treatment was uneventful. Electrolytic lesions comprised a central area of necrosis with a sharp demarcation between necrotic and viable pancreas. All animals developed transient hyperamylasemia after electrolysis. There was no significant difference between treatment and controls. Importantly, no animal had clinical, biochemical, or histological evidence of pancreatitis.
  
  
  CONCLUSIONS
  This experimental study suggested that electrolytic palliation of inoperable pancreatic cancer via the gastrointestinal tract is potentially safe. In patients, this treatment could be performed during endoscopic retrograde cholangiopancreatography and may have therapeutic advantages when compared to stenting or biliary bypass.
authors.affiliation: Department of Surgery University of Adelaide, The Queen Elizabeth Hospital, Woodville Road, Adelaide SA 5011, Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: Wemyss-Holden
authors.forename: F G
authors.initials: FG
authors.lastname: Court
authors.forename: C P
authors.initials: CP
authors.lastname: Morrison
authors.forename: B D
authors.initials: BD
authors.lastname: Teague
authors.forename: A
authors.initials: A
authors.lastname: Burrell
authors.forename: D R
authors.initials: DR
authors.lastname: Morales
authors.forename: N
authors.initials: N
authors.lastname: Rodgers
authors.forename: A A
authors.initials: AA
authors.lastname: Anthony
authors.forename: M S
authors.initials: MS
authors.lastname: Metcalfe
authors.forename: A R
authors.initials: AR
authors.lastname: Dennison
authors.forename: G J
authors.initials: GJ
authors.lastname: Maddern
mesh_terms: D000681:Amylases / Q000097:blood; D000818:Animals; D002097:C-Reactive Protein / Q000378:metabolism; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D007813:Laparotomy; D009336:Necrosis; D010166:Palliative Care / Q000379:methods*; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000601:surgery*; D013552:Swine; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein; D000681:Amylases