title: A pilot study of EUS-guided hot saline injection for induction of pancreatic tissue necrosis.
abstract: OBJECTIVE
  Hot saline may be potentially useful for inducing necrosis of pancreatic tissue. However, the local and systemic effects are largely unknown. This pilot study aimed to evaluate the feasibility and safety of EUS-guided injection of hot saline into the pancreas in the porcine model.
  
  
  METHODS
  Boiling hot saline was injected into the tail of normal porcine pancreas under EUS guidance in six pigs via a transgastric approach. Three pigs were killed 4 hours later to study the acute effect of the hot saline injection (acute study). The remaining three pigs were killed after 7 days of clinical observation (survival study).
  
  
  RESULTS
  Injection of 5 mL, 2 mL and 1 mL of hot saline produced localized necrosis (7 - 10 mm) of pancreatic tissue in the acute study. However, there was pooling of hot saline on the surface of the pancreas when 5mL was injected. On the basis of the results of the acute study, the volume of hot saline injected in the survival study was 1 mL. One milliliter of hot saline produced localized or sporadic necrosis of pancreatic tissue without any signs of pancreatitis in all three pigs in the survival study; hot saline was observed to pool on the pancreatic surface of one pig. There was no histological evidence of necrosis in the pancreatic tissue adjacent to the pooled hot saline in either the acute or the survival study.
  
  
  CONCLUSIONS
  EUS-guided hot saline injection of pancreatic tissue in the porcine model was technically successful and led to localized necrosis of pancreatic tissue without any sign of pancreatitis.
authors: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan 105-8461. himazu21@aol.com
authors: H
authors: H
authors: Imazu
authors: K
authors: K
authors: Sumiyama
authors: K
authors: K
authors: Ikeda
authors: Y
authors: Y
authors: Uchiyama
authors: H
authors: H
authors: Aihara
authors: H
authors: H
authors: Kakutani
authors: M
authors: M
authors: Kaise
authors: T L
authors: TL
authors: Ang
authors: S
authors: S
authors: Omar
authors: H
authors: H
authors: Tajiri
mesh_terms: D000818:Animals; D019160:Endosonography; D005240:Feasibility Studies; D006979:Hyperthermia, Induced / Q000379:methods*; D015552:Injections, Intralesional; D009336:Necrosis / Q000209:etiology / Q000473:pathology; D010179:Pancreas / Q000473:pathology*; D010865:Pilot Projects; D012965:Sodium Chloride / Q000008:administration & dosage*; D013552:Swine
chemical_list: D012965:Sodium Chloride