title: Irreversible electroporation (Nanoknife® treatment) in the field of hepatobiliary surgery: Current status and future perspectives.
abstract: OBJECTIVE
  We aimed to provide an overview of current understanding on the potential use of irreversible electroporation (IRE) in the field of hepatobiliary surgery with a focus on current results in hepatic and pancreatic cancers, its limitations, and its current directions.
  
  
  METHODS
  Through a review of the literature we have gathered the key articles and trials that are shaping our understanding of the current status of IRE and its prospective uses, and organized them in an easily understandable format showcasing the most up to date results.
  
  
  RESULTS
  IRE appears to be comparable in effectiveness and postoperative pain to the more established thermal ablation methods, while having the benefit of avoiding their detrimental thermal effects. In liver cancer, IRE was shown to be efficacious with low levels of local recurrences and only minimal complications. In pancreatic cancer it proved to have significant survival benefits but more significant (although rare) complications compared to the ones seen when IRE is used in liver cancer. Current evidence suggests a promising future for IRE, but clinical randomized control trials, and further developments of treatment protocols are required to come to more stable conclusions on the effectiveness and safety of IRE.
  
  
  CONCLUSIONS
  IRE is proving to be an adequate method for the treatment of tumors of the pancreas and liver in cases where traditional methods are unavailable. It has been proven particularly efficacious in patients with masses in close proximity to vital structures such as vessels, as well as major biliary and hepatic structures where thermal methods of ablation would cause significant complications.
authors.affiliation: St George's University of London Programme, University of Nicosia, 93 Agiou Nikolaou Street, Engomi, 2408 Nicosia, Cyprus.
authors.forename: Georgios
authors.initials: G
authors.lastname: Kourounis
authors.forename: Patrick
authors.initials: P
authors.lastname: Paul Tabet
authors.forename: Demetrios
authors.initials: D
authors.lastname: Moris
authors.forename: Alexandros
authors.initials: A
authors.lastname: Papalambros
authors.forename: Evangelos
authors.initials: E
authors.lastname: Felekouras
authors.forename: Fanourios
authors.initials: F
authors.lastname: Georgiades
authors.forename: George
authors.initials: G
authors.lastname: Astras
authors.forename: Athanasios
authors.initials: A
authors.lastname: Petrou
mesh_terms: D055011:Ablation Techniques; D018274:Electroporation; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*