Laser ablation of the biliary tree:<i>in vivo</i>proof of concept as potential treatment of unresectable cholangiocarcinoma

Saccomandi, Paola; Quero, Giuseppe; Gassino, Riccardo; Lapergola, Alfonso; Guerriero, Ludovica; Diana, Michele; Vallan, Alberto; Perrone, Guido; Schena, Emiliano; Costamagna, Guido; Marescaux, J.; Matteo, Francesco Maria Di

doi:10.1080/02656736.2018.1427287

Cited by 10 publications

(5 citation statements)

References 42 publications

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“…The problem of thermal injury to the bile ducts is also discussed in the context of radiofrequency ablation (RFA) of malignant hepatic lesions. 32 Just like MES, RFA relies on the effects of HF electrical current, which, apart from causing a significant temperature rise at the site of its application, also results in thermal injury to the bile ducts in the vicinity of the lesion. 33 Preserving the bile ducts and the surrounding structures from thermal damage and the investigation of intraluminal thermometry methods are actual issues of modern oncology.…”

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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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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“…In recent decades, endoscopic radiofrequency ablation has been introduced into clinical use to palliate unresectable cholangiocarcinoma 1 2 ; however, it has not been possible to perform this technique under direct visualization. A preclinical study has been reported on laser ablation in the biliary system 3 . A few authors have also reported using intraductal cholangioscopy-guided laser dissection for benign pancreatic/biliary ductal strictures 4 5 .…”

Section: Figmentioning

confidence: 99%

Laser ablation under intraductal cholangioscopic guidance for cholangiocarcinoma

Xia¹,

Hu²,

Zhang³

et al. 2023

Endoscopy

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“…Among them, stands Laser Ablation (LA), which exploits the absorption of laser light by the tissue to increase the temperature and thus to induce the cellular necrosis. 4,5 In the specific case of liver or of other deep-laying organs, minimally invasive LA procedures can be implemented by delivering the laser beam through a miniaturized optical fiber applicator inserted in the skin via a needle.…”

Section: Introductionmentioning

confidence: 99%

Temperature profile reconstruction during tumor laser ablation using percutaneous all-fiber smart applicators

Bellone,

Bellezza Prinsi,

Serafini

et al. 2024

Optical Fibers and Sensors for Medical Diagnostics, Treatment, and Environmental Applications XXIV

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The paper discusses all-fiber applicators for the percutaneous laser ablation of tumors, which integrate very dense fiber Bragg grating arrays to add quasi-distributed sensing capabilities. First an assessment of the temperature map distribution reconstruction from the measurements is presented and the impact of some non-idealities is studied; then the developed probes are used to analyze different laser operating conditions, comparing the measurements in ex-vivo porcine livers with modeling expectations.

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Laser ablation of the biliary tree:in vivoproof of concept as potential treatment of unresectable cholangiocarcinoma

Abstract: The temperature distribution obtained through LA proved to induce a safe and effective intraductal coagulative necrosis of biliary ducts. These results represent the basis for further experiments on tumour-bearing models for the treatment of obstructive cholangiocarcinoma.

Cited by 10 publications

References 42 publications

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

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

Laser ablation under intraductal cholangioscopic guidance for cholangiocarcinoma

Temperature profile reconstruction during tumor laser ablation using percutaneous all-fiber smart applicators

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