title: Thermal Ablation of the Pancreas With Intraoperative High-Intensity Focused Ultrasound: Safety and Efficacy in a Porcine Model.
abstract: New focal destruction technologies such as high-intensity focused ultrasound (HIFU) may improve the prognosis of pancreatic ductal adenocarcinoma. Our objectives were to demonstrate the safety and efficacy of intraoperative pancreatic HIFU ablation in a porcine model.
  
  
  
  In a porcine model (N = 12), a single HIFU ablation was performed in either the body or tail of the pancreas, distant to superior mesenteric vessels. All animals were sacrificed on the eighth day. The primary objective was to obtain an HIFU ablation measuring at least 1 cm without premature death.
  
  
  
  In total, 12 HIFU ablations were carried out. These ablations were performed within 160 seconds and on average measured 20 (15-27) × 16 (8-26) mm. The primary objective was fulfilled in all but 1 pig. There were no premature deaths or severe complications. High-intensity focused ultrasound treatment was associated with a transitory increase in amylase and lipase levels, and pseudocysts were observed in half of the pigs without being clinically apparent. All ablations were well delimited at both gross and histological examinations.
  
  
  
  Intraoperative thermal destruction of porcine pancreas with HIFU is feasible. Reproducibility and safety have to be confirmed when applied close to mesenteric vessels and in long-term preclinical studies.
authors.affiliation: From the *Department of Surgical Oncology, Centre Léon Bérard; and †Univ Lyon, INSERM, LabTau, Lyon, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Dupré
authors.forename: David
authors.initials: D
authors.lastname: Melodelima
authors.forename: Hannah
authors.initials: H
authors.lastname: Pflieger
authors.forename: Yao
authors.initials: Y
authors.lastname: Chen
authors.forename: Jérémy
authors.initials: J
authors.lastname: Vincenot
authors.forename: Anthony
authors.initials: A
authors.lastname: Kocot
authors.forename: Stéphan
authors.initials: S
authors.lastname: Langonnet
authors.forename: Michel
authors.initials: M
authors.lastname: Rivoire
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005240:Feasibility Studies; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery / Q000628:therapy*; D011379:Prognosis; D015203:Reproducibility of Results; D013552:Swine