Intraductal thermal injury using a heat probe and radiofrequency ablation electrode in a swine model of biliary stenosis

Shin, Jae Uk; Lee, Kwang Hyuck; Kim, Sua; Choi, Ji Hun; Kim, Kwang Min; Lee, Jong Kyun; Lee, Kyu Taek; Choi, Yoon‐La

doi:10.1016/j.clinre.2012.04.013

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…It may be concluded that the potential for stricture formation will remain low based on the histologic appearance of tissue healing, and results from prior studies (9). These results can also be compared with RFA of the bile duct where stricture formation typically occurred within 7 days of treatment (4,5).…”

Section: Discussionmentioning

confidence: 99%

Transmural ablation of the normal porcine common bile duct with catheter-directed irreversible electroporation is feasible and does not affect duct patency

Ueshima

Schattner

Mendelsohn

et al. 2018

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

Transmural ablation of the normal porcine common bile duct with catheter-directed irreversible electroporation is feasible and does not affect duct patency

Ueshima

Schattner

Mendelsohn

et al. 2018

Gastrointestinal Endoscopy

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“…At the same time, considering the nonlinearity of heat propagation, the variation of peak temperatures and the factors affecting these parameters, the clinical significance of the lab experiment, and the potential for extrapolating its findings to clinical practice might be lower than for the modeling approach chosen by us.As a rule, experimental models of bile duct strictures rely on longer thermal exposure. 25,43 However, the longest observation period between the surgical procedure and euthanasia of the animal in such experiments does not exceed 2 weeks, rendering it impossible to draw robust conclusions about the consequences of thermal injury to the bile ducts. Bile duct strictures take long to form.…”

Section: Discussionmentioning

confidence: 99%

“…As a rule, experimental models of bile duct strictures rely on longer thermal exposure. 25,43 However, the longest observation period between the surgical procedure and euthanasia of the animal in such experiments does not exceed 2 weeks, rendering it impossible to draw robust conclusions about the consequences of thermal injury to the bile ducts. Bile duct strictures take long to form.…”

Section: Discussionmentioning

confidence: 99%

Thermal Processes in Bile Ducts During Laparoscopic Cholecystectomy with Monopolar Instruments. Experimental Study Using Real-Time Intraluminal and Surface Thermography

et al. 2020

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Introduction. A significant rate of complications during laparoscopic cholecystectomy (LC) occurs due to thermal injury caused by monopolar electrosurgery (MES) equipment. Most of them manifest weeks and months after surgery with the common bile duct (CBD) and large duodenal papilla strictures, some in the early postoperative period with bile leaks. Objective. To study thermal processes occurring in the lumen and on the surface of the bile ducts during monopolar coagulation in a porcine model of LC. Methods. The temperature of the bile ducts was measured using instrumentation consisted of biliary stent with temperature sensors, which was inserted in the porcine CBD, signal amplifier, and current sense transformer. Surface temperature was measured with a scientific grade thermal camera. Cholecystectomy was performed using a standard “critical view of safety” (CVS) approach with 5 mm monopolar laparoscopic instruments. Results. Application of MES caused significant tissue heating. Lateral thermal spread and the rate of tissue heating depended on the duration of energy application and the initial tissue temperature. In 5 out of 6 experiments, the intraluminal temperature rose up to the critical threshold, and the exposure time ranged from 54 to 560 seconds. A sensor positioned at the papilla site was heated in all the experiments but still below the cell damage inducing threshold. The analysis of thermographic charts revealed the presence of the “current channeling” effect and the pedicle effect. Conclusion. There is a possibility of a direct and delayed thermal injury to the bile ducts during LC.

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“…One of the pigs subjected to ligation later developed obstructive jaundice and expired as an unfortunate and unavoidable complication. An alternative porcine biliary stricture model, using heat probes and radiofrequency ablation,17 was inappropriate for our purposes, given the detrimental effects on biliary histology.…”

Section: Discussionmentioning

confidence: 99%

Safety Evaluation of Paclitaxel-Eluting Biliary Metal Stent with Sodium Caprate in Porcine Biliary Tract

et al. 2019

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Background/Aims Metallic stents designed to relieve malignant biliary obstruction are susceptible to occlusive tumor ingrowth or overgrowth. In a previous report, we described metallic stents covered with paclitaxel-incorporated membrane (MSCPM-I, II) to prevent occlusion from tumor ingrowth via antitumor effect. This new generation paclitaxel-eluting biliary stent is further endowed with sodium caprate (MSCPM-III) for enhanced drug delivery. The purpose of this study is to examine the safety of its drug delivery system in the porcine biliary tract. Methods MSCPM-III (10% [wt/vol] paclitaxel) and covered metal stents (CMSs) were endoscopically inserted in porcine bile ducts in vivo . Histologic biliary changes, levels of paclitaxel released, and various serum analytes (albumin, alkaline phosphate, aspartate transaminase, alanine transaminase, total protein, total bilirubin, and direct bilirubin) were assessed. Results Based on the intensity of reactive inflammation and fibrosis, changes in porcine biliary epithelium secondary to implanted MSCPM-III were deemed acceptable (i.e., safe). Histologic features in the MSCPM-III and CMS groups did not differ significantly. In a related serum analysis, paclitaxel release from MSCPM-III stents was below the limit of detection for 28 days. Biochemical analyses were also similar for the two groups, and no evidence of hepatic or renal toxicity was found in animals receiving MSCPM-III stents. Conclusions In a prototypic porcine trial, this newly devised metal biliary stent incorporating both paclitaxel and sodium caprate appears to be safe in the porcine bile duct.

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Intraductal thermal injury using a heat probe and radiofrequency ablation electrode in a swine model of biliary stenosis

Cited by 10 publications

References 17 publications

Transmural ablation of the normal porcine common bile duct with catheter-directed irreversible electroporation is feasible and does not affect duct patency

Transmural ablation of the normal porcine common bile duct with catheter-directed irreversible electroporation is feasible and does not affect duct patency

Thermal Processes in Bile Ducts During Laparoscopic Cholecystectomy with Monopolar Instruments. Experimental Study Using Real-Time Intraluminal and Surface Thermography

Safety Evaluation of Paclitaxel-Eluting Biliary Metal Stent with Sodium Caprate in Porcine Biliary Tract

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