A safe method for rapid therapeutic pancreatic cooling.

ABSTRACT

Acute pancreatitis (AP) has no targeted therapy. Previously, pancreatic cooling to 31°C-33°C and 24°C-27°C, respectively, ameliorated mild and severe AP in rats. Here, Yucatan pigs (40-50Kg) whose abdominal size and anatomy are like humans underwent pancreatic cooling. This was via a gastric cooling balloon placed endoscopically with catheters exteriorized on the abdominal wall. Laparoscopically placed wireless transmitters monitored pancreas tail, head, and urinary bladder temperatures. Controls included un-perfused water filled balloons, and sedation-only groups. Tap water perfusion (375 mL/min) over 1-month was well tolerated without sedation. Perfusion with ≤19°C water achieved pancreatic temperatures ≤32°C and perfusion at ≤10°C achieved ≤26°C in <90 min in sedated supine pigs, which normalized an hour after balloon evacuation. Bladder temperatures, behavioral, biochemical, hematological, and histological parameters were similar between groups. Therefore, rapid transgastric pancreatic cooling can be achieved safely in large animals with relevant anatomy like humans, warranting future clinical studies.