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 day 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 pseudocyst 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.