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CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR 2025; 09(01): 028-039
DOI: 10.1055/s-0045-1801889
Review Article

Complications of Percutaneous Irreversible Electroporation for Pancreatic Cancer: A Systematic Review

Harsimran Bhatia
1   Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Muniraju Maralakunte
1   Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Mudita Gulati
1   Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Vishal Sharma
2   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Pankaj Gupta 
1   Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Funding None.
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Abstract

Purpose The aim of the study was to systematically review the percutaneous irreversible electroporation (IRE) complications for pancreatic ductal adenocarcinoma (PDAC).

Methods This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers conducted a detailed search in PubMed and EMBASE databases from inception till May 2024. The studies reporting the complications of percutaneous IRE in PDAC using standard scales were included. The primary outcome of interest was the complication rate (including total number of complications and major and minor complications) associated with the percutaneous IRE. IRE-related mortality was also recorded.

Results Of the 2,324 studies, 14 (9 prospective and 3 retrospective) met the inclusion criteria. Of the 748 complications, 114 were major complications (15.2%) and 634 were minor complications (84.7%). The most common complications were abdominal pain (n = 137), diarrhea (n = 57), and nausea and/or vomiting (n = 45). Pancreatitis (n = 57), vascular thrombosis (n = 21), bleeding (n = 21), and biliary complications (n = 26), including bile leaks, cholangitis, and strictures, were other common complications. The overall IRE mortality was 4/584 (0.68%). IRE-related fatal complications included duodenal perforation (n = 2), hepatic artery and superior mesenteric artery thrombosis (n = 1), and purulent peritonitis (n = 1).

Conclusion Although complications are common after IRE for PDAC, most are minor complications. Major complications include bleeding and pancreaticobiliary complications.

Keywords

irreversible electroporation - pancreatic cancer - complications

Ethics Approval

As per the institute ethics committee, ethical approval is not required for systematic review and meta-analysis.


Availability of Data and Materials

All data associated with the manuscript have been presented in the paper.


Authors' Contributions

H.B., M.G., M.M. screened the studies, extracted data, performed quality assessment, and wrote the initial draft. V.S. and P.G. wrote the initial draft and critically revised the manuscript.




Publication History

Article published online:
03 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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