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Charles P. Morrison, Benjamin D. Teague, Fiona G. Court, Simon A. Wemyss-Holden, Mathew S. Metcalfe, Ashley R. Dennison, Guy J. Maddern
Med Sci Monit 2003; 9(1): BR43-46
BACKGROUND: Pancreatic cancer has a poor prognosis, with symptomatic palliation being the priority in the majority of cases. Alternative palliative techniques, such as local ablation, are under investigation. Palliative per-ductal electrolytic ablation of the pancreas has been reported, in an experimental series. It is important to establish that this technique is associated with low morbidity and mortality if it is to be acceptable. The 'systemic inflammatory response syndrome' (SIRS) is a recognised and serious complication of both acute pancreatitis, and certain locally ablative techniques. This study aimed to determine whether pancreatic electrolytic ablation is associated with an increase in serum IL-1ß and TNF-α concentrations, these cytokines playing integral roles in the inflammatory pathway of SIRS. MATERIAL/METHODS: Eight pigs underwent per-ductal electrolytic ablation of the pancreas. Serum samples, taken pre-operatively and post-operatively for two weeks, were analysed for IL-1ß and TNF-α concentrations. Variations in cytokine levels were statistically analysed. RESULTS: Post-operative serum IL-1ß and TNF-α concentrations did not significantly increase on pre-operative figures. There were no other clinical, biochemical or histological indicators of a SIRS-like phenomenon. CONCLUSIONS: The results from this study suggest that electrolytic ablation of normal pancreas is not associated with either an increase in serum concentrations of IL-1ß and TNF-α or a SIRS phenomenon. Although this study has only investigated the serum levels of two cytokines, IL-1ß and TNF-α have both been shown to have a central role in the inflammatory cascade that leads to SIRS.