Radiofrequency ablation of the pancreas. II: Intra-operative ablation of non-resectable pancreatic cancer. A description of technique and initial outcome.

CONTEXT There is little reported experience of radiofrequency ablation of pancreatic tumours. Our group has reported the development of a porcine pancreatic model of radiofrequency ablation of the pancreas. This brief report details the application of this technique to clinical practice. CASE REPORT A 58-year-old man with metastatic pancreatic tumour underwent operative radiofrequency ablation. An operative approach was utilised to protect the stomach and transverse colon and also to prevent thermal injury to the inferior vena cava. In addition, the operative technique was combined with prophylactic hepaticojejunostomy and gastrojejunostomy to anticipate ablation-related biliary injury or duodenal stenosis. A post-ablation CT scan two weeks after the procedure confirmed radiological evidence of ablation. The patient remained well until his death, 3 months after surgery. CONCLUSION This report demonstrates that operative radiofrequency ablation is feasible and was safely carried out in this case. More experience is required to assess the spectrum of complications and if there is true oncological efficacy.