Endoscopic ultrasound-guided ethanol injection in the pancreas in a porcine model: a preliminary study.
OBJECTIVE
Despite aggressive multimodal treatments, survival rates for patients with pancreatic cancer remain disappointing. Local progression is problematic, and minimally invasive procedures allowing locoregional control are needed. In this study, we attempted endoscopic ultrasound (EUS)-guided injection of ethanol into the pancreas.


METHODS
Under EUS guidance, pure ethanol (2 mL) was injected into normal tissue of the pancreatic body in two anesthetized domestic pigs. Serum concentrations of amylase, aspartame aminotransferase, alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase were measured before treatment and at 2 h, 48 h and 2 weeks after injection. Body weight and clinical signs were also observed. After the animals were euthanized, the pancreases were analyzed histologically.


RESULTS
EUS imaging allows real-time surveillance of the injection procedure. Mild diarrhea was noted in one animal, but no other adverse effects were observed. No marked changes in laboratory tests were noted. Histologically, parenchymal necrosis extending over a wide area was seen without severe inflammation.


CONCLUSIONS
EUS-guided ethanol injection in the pancreas seems to be technically simple. More detailed assessments of the safety and dose-effect relationship issues associated with this procedure are required.
Matsumoto
Kakuya
K
Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan. kmatsumo@asahikawa-med.ac.jp
Yamao
Kenji
K
Okubo
Kenji
K
Hara
Kazuo
K
Sawaki
Akira
A
Mizuno
Nobumasa
N
Tajika
Masahiro
M
Kawai
Hiroki
H
Ashida
Reiko
R
D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D019160:Endosonography; D004798:Enzymes / Q000097:blood; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D007267:Injections; D023421:Models, Animal; D009336:Necrosis; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000201:enzymology / Q000473:pathology; D010865:Pilot Projects; D034421:Sus scrofa; D013997:Time Factors
D000970:Antineoplastic Agents; D004798:Enzymes; D000431:Ethanol