Concentration-dependent ablation of pancreatic tissue by EUS-guided ethanol injection.
BACKGROUND
Ethanol is a commonly available agent and has been used to successfully and safely ablate cystic lesions of various organs.


OBJECTIVE
The aim of this study was to determine the short-term effects of an EUS-guided injection of ethanol into the pancreas of pigs by using 2 mL ethanol, in increasing concentration of 0% to 100%.


METHODS
Six pigs were sedated by general anesthesia, and ethanol was injected, under EUS-guidance, with a 22-gauge needle into the pancreatic tail.


METHODS
End points of this study were gross and microscopic evidence of pancreatitis and clinical tolerance. During the 7-day observational period, the animals were monitored by serum levels of amylase and lipase and by a CT on day 4.


RESULTS
At euthanasia, there was no pancreatic lesion in the animals that received normal saline solution or 20% ethanol. The injection of 40% to 100% ethanol led to a visible necrotic area in the pancreatic tail. By histology, the average maximal diameter of the lesions was 20.8 +/- 4.3 mm. The cross-sectional area of necrosis was proportional to the concentration of ethanol (r = 0.961). CT demonstrated a localized site of nonenhancing pancreatic tissue, with an average diameter of 19.4 +/- 10.5 mm; 40% to 100% ethanol. Clinically, the animals appeared to tolerate the procedure without sequelae. Serum levels of amylase and lipase were normal.


CONCLUSIONS
The EUS-guided injection of ethanol into the pig pancreas resulted in a localized concentration-dependent tissue necrosis without complications.
Matthes
Kai
K
Gastrointestinal Unit, Gastrointestinal Pathology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Mino-Kenudson
Mari
M
Sahani
Dushyant V
DV
Holalkere
Nagaraj
N
Brugge
William R
WR
D000818:Animals; D004305:Dose-Response Relationship, Drug; D019160:Endosonography; D000431:Ethanol / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D007267:Injections; D008297:Male; D023421:Models, Animal; D009336:Necrosis; D010179:Pancreas / Q000187:drug effects* / Q000473:pathology; D019999:Pharmaceutical Solutions / Q000008:administration & dosage*; D013552:Swine
D019999:Pharmaceutical Solutions; D000431:Ethanol