Feasibility of EUS-guided Nd:YAG laser ablation of unresectable pancreatic adenocarcinoma

Francesco Maria Di Matteo, Paola Saccomandi, Margareth Martino, Monica Pandolfi, Margherita Pizzicannella, Valerio Balassone, Emiliano Schena, Claudio Maurizio Pacella, Sergio Silvestri, Guido Costamagna

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aims: EUS has become an interventional technique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer. Methods: Patients with stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemoradiotherapy. LA was performed by using a 300-μm flexible fiber preloaded onto a 22-gauge fine needle. A 1064-nm wavelength neodymium-yttrium aluminum garnet (Nd:YAG) laser light with different power settings of 2 W for 800 J, 1000 J, and 1200 J; 3 W for 800 J, 1000 J, and 1200 J; and 4 W for 800 J, 1000 J, and 1200 J was used. Each patient was treated with a single application of 1 of these settings. The application time of the power settings ranged from 200 to 600 seconds. Results: Nine patients (median age, 74.7; range 55-85) underwent Nd:Yag LA. The mean size of the focal lesion was 35.4 mm (range, 21-45). The ablation area, demonstrated by 24-hour CT, ranged from.4 cm3 (for the lower power setting of 2 W/800 J) to a maximum of 6.4 cm3 (for 4 W/1000 J). The procedure was completed in all 9 patients without adverse events. Conclusion: In our human experience, EUS-guided LA was feasible and well tolerated in patients with UR pancreatic cancer.

Original languageEnglish
Pages (from-to)168-174.e1
JournalGastrointestinal Endoscopy
Volume88
Issue number1
DOIs
Publication statusPublished - Jul 1 2018

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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