不可逆电穿孔是治疗局部晚期胰腺腺癌的一种新方法。然而，这种消融技术并非没有风险，并且有可能引发不良事件。本研究的目的是描绘增加这种风险的风险因素，并阐明局部晚期胰腺癌中与不可逆电穿孔相关的风险状况。对 2015 年 12 月至 3 月我们的前瞻性多机构数据库的回顾对 2022 名接受不可逆电穿孔的局部晚期胰腺癌患者的不良事件进行了分析。然后将这些患者与因腺癌而接受胰腺切除术的对照患者群体进行比较。接受不可逆电穿孔治疗的 201 名患者中，有 51 名患者发生了不良事件，而接受胰腺切除术治疗的 200 名患者中，有 78 名患者发生了不良事件。不可逆电穿孔组3C期患者术后腹水发生率明显更高。不可逆电穿孔组最常见的并发症是感染（n = 13）、胃肠道出血（n = 11）和腹水（n = 7）。多变量分析表明，接受高剂量新辅助放疗（风险比，2.4；95%置信区间，1.4-5.4）、不可逆电穿孔电极包围肠系膜上动脉的不可逆电穿孔队列中，严重（≥3级）不良事件的风险增加、肠系膜上静脉和门静脉静脉（风险比，1.9；95% 置信区间，1.3-3.4），以及胆管支架置入时间 > 6 个月（风险比，1.7；95% 置信区间，1.2） -5.6）。两组的 90 天死亡率相似，不可逆电穿孔为 2.4%，胰腺切除术为 2.8%。这项研究显示，局部晚期胰腺腺癌中与不可逆电穿孔相关的不良事件发生率为 25%，显着较低（P = . 004）比早期疾病中胰腺切除术相关的不良事件发生率高出 39%。不可逆电穿孔组中某些独特的不良事件已经确定，在护理这些患者时应该了解这些不良事件。版权所有 © 2023 Elsevier Inc. 保留所有权利。

Irreversible electroporation is a novel approach for treating locally advanced pancreatic adenocarcinoma. However, this ablative technique is not without risk and has the potential to precipitate adverse events. The aim of this study was to delineate risk factors that increase this risk, as well as to elucidate the risk profile associated with irreversible electroporation in the setting of locally advanced pancreatic adenocarcinoma.A review of our prospective multi-institutional database from December 2015 to March 2022 of patients with locally advanced pancreatic adenocarcinoma who underwent irreversible electroporation was analyzed for adverse events. These were then compared with a control population of patients undergoing pancreatectomy for adenocarcinoma.Adverse events occurred in 51 patients of the 201 patients treated with irreversible electroporation compared with 78 of the 200 patients treated with pancreatectomy. The irreversible electroporation group had a significantly greater incidence of postoperative ascites in stage 3C patients. The most common complications in the irreversible electroporation group were infectious (n = 13), gastrointestinal bleed (n = 11), and ascites (n = 7). Multivariate analysis demonstrated increased risk of severe (grade ≥3) adverse events in the irreversible electroporation cohort who received high dose, neoadjuvant radiation (hazard ratio, 2.4; 95% confidence interval, 1.4-5.4), irreversible electroporation electrodes bracketing the superior mesenteric artery, superior mesenteric vein, and portal venous vein (hazard ratio, 1.9; 95% confidence interval, 1.3-3.4), and who had a bile duct stent in place for >6 months (hazard ratio, 1.7; 95% confidence interval, 1.2-5.6). There were similar rates of 90-day mortality in both groups, irreversible electroporation 2.4% vs pancreatectomy 2.8%.This study revealed a 25% rate of adverse events associated with irreversible electroporation in locally advanced pancreatic adenocarcinoma, which was significantly less (P = .004) than the 39% rate of adverse events associated with pancreatectomy in early-stage disease. Certain unique adverse events in the irreversible electroporation group have been established and should be understood in the care of these patients.Copyright © 2023 Elsevier Inc. All rights reserved.