TECHNICAL DETAILS AND RESULTS OF CRYOABLATION IN PANCREATIC CANCER

Abstract

Aim: To improve the results of treatment of terminal stage pancreatic cancer. Materials and methods. Since 2012 cryosurgery was performed in 45 patients - 20 men (44.4%) and 25 women (55.6%) with pancreatic cancer. With mean age of 59 ± 3 years. The head of the pancreas was struck in 20 (44.4%) cases, a head-body - in 13 (28.9%), the body - in 12 (26.7%). The following distribution of patients depending on pacreatic cancer stages were noted: stage IV- 34 patients, stage III- 11. In 8 patients with pancreatic cancer and liver metastases simultaneous cryodestruction of tumorsof the pancreas and liver malformations were performed. Local cryodestruction has been supplemented by bypass in 29 cases (64.4%). In one case, cryosurgery was performed on segment of the portal vein after the pankreatoduoenal resection. All patients subsequently were underwent adjuvant chemotherapy, supplemented by regional chemoembolization in 10 cases.Results. We proposed indications and contraindications for cryoablation. Intraperitoneal bleeding was diagnosed in 2 (4.4%) cases. Acute pancreatitis - in 5 (11.1%) cases. Suppuration manipulation area was noted in 2 (4.4%) cases. Ascites was detected in 9 (20.0%) patients (docked within 5-8 days therapeutically). Wound supporation was observed in 2 (4.4%) cases. Complete pain relief atchieved after cryoablation was reached in 38% of cases or significant reduction of its intensity in 41%. Kaplan-Meier survival in patients with pancreatic cancer for 6 months was 56%, for 12 months - 28%, for 24 months -15% and for 28 months - 4.3%.Conclusion. Сryodestruction for cancer of the pancreas in patients with unrespectable tumors improves the quality of life of cancer patients, primarily due to decrease pain intensity. Application of chemotherapy improves quality of life and can prolong survival rates.

Keywords

• cryosurgery
• cryodestruction
• cryoapplicator
• cryoprobe
• pancreatic malignancy