Percutaneous cryoablation for pancreatic cancer with ultrasonography and computed tomography guidance

Objective To establish the standard technique of percutaneous cryoablaton for pancreatic cancer, assess the safety and feasibility of percutaneous cryoablation with ultrasonography(US) and computed tomography(CT) guidance in the treatment of pancreatic cancer. Methods review of 85 cases of pancreatic cancer who underwent cryoablations conducted from November 2008 to May 2010 was observed. Cryocare surgical system and cryoprobes in 1.7~2 cm were adopted. One to eight cryoprobes were supplied for each cryoablation. Transabdominal or transdorsal approach was performed for body and tail of pancreatic cancer, while transabdominal approach for head of pancreatic cancer. Two cycles of fast freezing with argon at (-160 ± 10)℃ for 5~10 min and thawing with helium at (15 ± 5)℃ for 5~10 min were performed for each ablation. CT, karnofsky performance status(KPS), cryoablation-related complications and hospital length of stay were analyzed. Results One hundred and twenty-one percutaneous cryoablaitons were performed successfully without deaths. Complications were relative infrequent, all of which were controlled well with conventional treatment. All cryolesions presented inactive status after cryoablation, and the average diameter of tumors decreased [(4.7 ± 0.3) vs. (4.1 ± 0.4), P < 0.01]. KPS increased [(80.0 ± 0.6) vs. (90.0 ± 0.4), P < 0.01]. Hospital length of stay was significantly shorter than of intraoperative cryoablations (P < 0.05). Conclusions Percutaneous cryoablation with US and CT guidance is a safe and feasible technique for pancreatic cancer with relatively rare and mild complications and irrefutably ablative effect, which provides an optimistic alternative therapy for pancreatic cancer. Key words: Percutaneous cryoablation; US & CT guidance; Pancreatic cancer