Endoluminal radiofrequency ablation versus glue for preventing pancreatic fistula: a preclinical protocol study

Postoperative pancreatic fistula (POPF) complicates 9.9-28.5% of pancreatic surgeries. This protocol describes a preclinical study in a large animal model comparing endoluminal radiofrequency ablation (ERFA) and glue occlusion of the main pancreatic duct (MPD), both performed four weeks prior to surgery to induce pancreatic atrophy and potentially reduce the risk of POPF. In this randomized study, healthy pigs were allocated to either the ERFA or the glue occlusion groups. The protocol comprises three sequential procedures: (1) MPD occlusion via a hybrid laparoscopic or robotic approach, (2) minimally invasive pancreatic transection at four weeks, and (3) necropsy 15 days post-transection. This study addresses the technical challenges of manipulating pancreatic ducts in large animals and provides a standardized approach for evaluating MPD occlusion techniques. The methodology enables a robust comparison between ERFA and glue occlusion while accounting for anatomical variations between porcine and human models to support future clinical applications.