E1646. Irreversible Electroporation of the Pancreas: A Decade On
  1. Daniel Ong; Tan Tock Seng Hospital
  2. Uei Pua; Tan Tock Seng Hospital
Irreversible electroporation (IRE) employs the use of an electric field to cause irreversible permeability of the cell membrane, inducing apoptosis. The use of IRE for locally advanced pancreatic cancer (LAPC) was first described in 2012. The crucial advantage of IRE compared with other devices employing thermal ablation is the safety around vital structures such as vessels and ducts. This makes it an attractive option for use in the pancreas due to the close proximity of multiple major vascular structures, biliary ducts, and adjacent gastrointestinal organs. Over the past decade, IRE has grown to establish itself as a useful treatment adjunct, and may soon become standard of care, particularly so for LAPC.

Educational Goals / Teaching Points
To provide readers with an updated summary on the usage of IRE for locally advanced pancreatic cancer.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
IRE in pancreatic cancer include irreversible electroporation in pancreatic cancer, open, laparoscopic versus percutaneous irreversible electroporation, patient selection & preoperative management, outcome of irreversible electroporation for locally advanced pancreatic cancer, complications of irreversible electroporation, radiological response to irreversible electroporation, and future prospects.

The past decade has seen IRE grown into an established adjunct in the management of pancreatic cancer, particularly for LAPC. Percutaneous IRE provides a minimally invasive option of treatment, but due to its frequent association with major complications, it should be regarded as a high-risk procedure. IRE is a promising tool in the treatment of LAPC and may confer benefits in a carefully selected patient population.