This preclinical porcine study evaluated endoluminal radiofrequency ablation (ERFA) of the main pancreatic duct (MPD) performed 4 weeks before pancreatic transection as a strategy to reduce postoperative pancreatic fistula (POPF) risk. Outcomes were compared to MPD occlusion with cyanoacrylate glue, with necropsy at 15 days post-transection.
ERFA induced significantly greater acinar atrophy than glue occlusion at 4 weeks (p = 0.018). Pseudocyst formation and intra-abdominal adhesions — surrogate POPF markers in pigs — were absent in ERFA-treated animals but significantly more frequent in the glue group. Serum amylase, weight gain, complication rates, and endocrine architecture were comparable between groups.
- Animal (porcine) model only; direct translation to human outcomes is uncertain. - Sample size not explicitly reported in the abstract; statistical power may be limited. - Surrogate POPF markers (pseudocysts, adhesions) used in pigs may not map directly to clinical POPF definitions in humans.
Preoperative ERFA of the MPD is feasible and safe in a porcine model, producing more homogeneous exocrine atrophy and fewer fistula-related complications than glue occlusion. Clinical trials are needed before this approach can be considered for high-risk pancreaticoduodenectomy patients.
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