{
  "abstract": "Background and Aims Major pancreatic resections carry substantial morbidity (20–40%) and are often inappropriate for elderly or frail patients. At the same time, the increasing detection of small, incidental pancreatic lesions—such as pancreatic neuroendocrine tumours (pNETs) and cystic lesions—creates a growing management dilemma. Many patients are deemed unsuitable for surgery yet experience significant anxiety with a conservative surveillance strategy. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) provides a minimally invasive, parenchyma-sparing alternative that may address this unmet clinical need. This study describes our prospective experience evaluating the safety, feasibility, and intermediate-term efficacy of EUS-RFA for pancreatic and extra-pancreatic lesions.Methods A prospective single-centre cohort included >25 patients undergoing a total of 74 EUS-RFA procedures from 2022 onwards. All procedures were performed using a linear echoendoscope with a needle-based RFA system. Target lesions comprised established indications (pNETs), emerging indications (pancreatic cystic lesions), and investigational Tier 3 lesions (locally advanced pancreatic ductal adenocarcinoma, liver, and adrenal lesions). Clinical and radiological follow-up ranged from 6–18 months. Safety was assessed with particular attention to proximity to the main pancreatic duct (MPD), and efficacy was evaluated through radiological response and need for repeat sessions.Results Technical success was achieved in 98% of procedures. The overall complication rate was low at 4.05% (3/74), substantially lower than historical series (7–30%). Recorded adverse events included two cases of mild pancreatitis and one gastric wall thermal injury. Complete radiological response was achieved in 55.6% overall. Among those with residual disease, repeat ablation was effective—82% (14/17) demonstrated a response following a second session. For Tier 1 pNETs, EUS-RFA achieved high clinical efficacy (95.5%), comparable to surgical resection (100%) but with significantly lower procedural risk, consistent with recent propensity-matched analyses.Conclusion EUS-RFA is an effective, organ-sparing therapeutic option that bridges the gap between surveillance and major surgery for selected pancreatic and extra-pancreatic lesions. Our experience demonstrates high technical success, strong early efficacy, and low complication rates using modern precision-guided techniques. Wider adoption will benefit from standardised training pathways and participation in national registries and randomised controlled trials to refine indications and long-term outcomes.",
  "authors": [
    {
      "affiliations": [
        "University Hospitals of Leicester, Leicester, United Kingdom"
      ],
      "name": "Sudarshan Kadri"
    }
  ],
  "title": "FP38 A prospective single-centre experience on safety and long-term efficacy of EUS-guided radiofrequency ablation for pancreatic and extra-pancreatic lesions",
  "uid": "11f1f79c-f937-5b6b-b35a-46d1c81e79f5"
}