EUS-guided ethanol injection of normal porcine pancreas: a pilot study

Background: Ethanol injection is a potential means of EUS-guided pancreatic tissue ablation. The effects of injected ethanol on normal pancreas are unknown. Methods: Transgastric ethanol injection of the body and the tail of normal porcine pancreas was performed under EUS guidance in 8 anesthetized Yorkshire pigs: 98% ethanol was injected in 4 animals, and 50% ethanol was injected in 4 animals. Serum amylase levels were monitored, and EUS was repeated on day 7. Gross and histologic examination of the pancreas was performed on clay 7. Results: All 8 animals tolerated ethanol injection without signs of distress. An increase in amylase levels was seen in all animals. Focal areas, 2 to 6 mm, of inflammation, necrosis, and fibrosis were observed after 50% ethanol injection. Larger (8-30 mm) areas of inflammation, necrosis, and fibrosis were seen after 98% ethanol injection, as well as one fluid collection and one colonic stricture. Conclusions: Injection of 50% ethanol into normal porcine pancreas results in focal inflammation, necrosis, and fibrosis at the injection site. Ethanol injection (98%) produces larger areas of inflammation, fibrosis, and necrosis, with local complications of pancreatitis.