Long-term results of temperature-controlled endobiliary radiofrequency ablation in a normal swine model

Cho, Jae Hee; Jeong, Seok; Kim, Eui Joo; Kim, Joon Mee; Kim, Yeon Suk; Lee, Don Haeng

doi:10.1016/j.gie.2017.09.013

Cited by 42 publications

(56 citation statements)

References 11 publications

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“…There were no adverse events, such as bile duct perforation or bleeding, in the 12 mini pigs used in that study. In another animal study, the long‐term effects of endobiliary RFA included the development of segmental stricture with cholangitis, but neither bleeding nor perforation was observed during the 28 days after endobiliary RFA …”

Section: Discussionmentioning

confidence: 99%

“…In another animal study, the long-term effects of endobiliary RFA included the development of segmental stricture with cholangitis, but neither bleeding nor perforation was observed during the 28 days after endobiliary RFA. 12 Our study was performed to evaluate the safety of temperaturecontrolled endobiliary RFA using the new RF catheter, before a prospective, controlled, comparative clinical study is conducted. There were no adverse events that suggested significant injury of the vessels or the bile duct.…”

Section: Discussionmentioning

confidence: 99%

“…The power is automatically stopped whenever the temperature of the electrodes reaches the preset target temperature, so that unintended overheating is avoided . In previous studies of this RF catheter in a normal swine model, heat energy values that would allow clinical application were determined and the early and long‐term effects on the swine bile duct were evaluated . The present study is a preliminary analysis before a prospective randomized controlled trial to evaluate the efficacy of this RF catheter.…”

Section: Introductionmentioning

confidence: 99%

“…11 In previous studies of this RF catheter in a normal swine model, heat energy values that would allow clinical application were determined and the early and long-term effects on the swine bile duct were evaluated. 11,12 The present study is a preliminary analysis before a prospective randomized controlled trial to evaluate the efficacy of this RF catheter. Our aim was to confirm the clinical safety of temperature-controlled endobiliary RFA using the newly developed catheter for the treatment of extrahepatic MBS.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study

Lee

Jeong

Choi

et al. 2019

J of Gastro and Hepatol

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Background and Aims Catheter‐based endobiliary radiofrequency ablation (RFA) is an endoscopic local treatment for patients with malignant biliary stricture (MBS). However, excessive heating of the bile duct by the current RFA system can induce serious complications. Recently, a new RFA system with automatic temperature control was developed. In the present study, we examined the safety of the new RFA system in patients undergoing endobiliary RFA for extrahepatic MBS. Methods This prospective, multicenter study enrolled patients with unresectable or inoperable extrahepatic (> 2 cm from the hilum) MBS. Endobiliary RFA was performed using a newly developed RFA catheter (ELRA™, STARmed, Goyang, Korea) at a setting of 7 or 10 W for 120 s and with a target temperature of 80°C. A self‐expandable metallic stent was inserted after endobiliary RFA. The rate of procedure‐related adverse events was assessed. Results The 30 patients were enrolled in this study. Cholangiocarcinoma was diagnosed in 19 patients, pancreatic cancer was found in 9, and gallbladder cancers were recorded in 2. The mean stricture length was 22.1 ± 6.6 mm. Post‐procedural adverse events occurred in three patients (10.0%; 2 mild pancreatitis and 1 cholangitis) without hemobilia and bile duct perforation. The pancreatitis and cholangitis resolved with conservative treatment. The cumulative duration of stent patency and survival were 236 and 383 days, respectively. Conclusions Automatic temperature‐controlled endobiliary RFA using a newly developed catheter was safely applied in patents with extrahepatic MBS. Further prospective studies are needed to confirm the efficacy of endobiliary RFA for MBS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study

Lee

Jeong

Choi

et al. 2019

J of Gastro and Hepatol

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“…Intraductal RFA with an endobiliary catheter (Habib EndoHPB; EMcision, London, UK) has been designed to potentially improve the stent patency and survival rates [11,12]. However, because of heat sink and thermal injury, its clinical use was confined by the risk of treatment-related complications and limited efficacy [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Acute and Subacute Effects of Irreversible Electroporation on Normal Common Bile Ducts in a Rabbit Model

Liu

Ren

Zhang

et al. 2020

Preprint

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Background This study aimed to evaluate the acute and subacute effects of irreversible electroporation (IRE) on normal common bile ducts (CBDs) in a rabbit model. Methods Cell susceptibility to IRE was assessed in vitro with cholangiocarcinoma and normal cell lines at varying voltages. The distributions of electric field and temperature were evaluated with a two-dimensional simulation model of common bile duct. In vivo bile duct IRE ablation was performed in 28 adult New Zealand rabbits. Liver function assessments and cholangiography were performed post-IRE to evaluate biliary complications. The biliary tract was extracted en bloc and histopathological analyses were performed using hematoxylin-eosin (H&E) and Masson trichrome (MT) staining, and terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL) assay. Results Different cells showed different susceptibility to the effect of IRE, cancer cell line HUCC-T1 was the least sensitive to IRE. Simulations predicted the distributions of electric field and temperature during IRE process, and the maximum temperature of tissue was below 43°C. In all animals, biliary dilatation and stricture were observed in 4/28 animals respectively by postoperative days 7, 14, and 28. H&E staining revealed complete cell death with inflammatory infiltration, edema, and hemorrhage. Bile duct epithelial recovery was completed between post-IRE days 7–28. Conclusions The normal CBD retains the lumen wall integrity and function following IRE with immediate periductal placement of the electrode. However, the parameters of cholangiocarcinoma IRE ablation need to be determined more precisely to ensure the treatment efficacy and reduce the risk of collateral damage.

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Acute and subacute effects of irreversible electroporation on normal common bile ducts in a rabbit model

Liu

Ren

Zhang

et al. 2020

J Hepato Biliary Pancreat

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BACKGROUND Malignant biliary tumors are uncommon and usually diagnosed following malignant biliary obstruction. 1 Surgical resection is currently the only potential curative treatment for early recognition and diagnosis. However, a majority of patients present late in the course of disease with only 20%-40% resectable cases due to the advanced tumor stage at the time of diagnosis, and of these potentially resectable tumors, R 0 resection is not always achieved. 2 Therefore, placement of biliary stents is typically chosen as palliative management for biliary decompression with an estimated life expectancy of approximately 3-6 months. 3,4 Compared with surgical interventions, biliary stents offer shorter durations

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Long-term results of temperature-controlled endobiliary radiofrequency ablation in a normal swine model

Cited by 42 publications

References 11 publications

The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study

The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study

Acute and Subacute Effects of Irreversible Electroporation on Normal Common Bile Ducts in a Rabbit Model

Acute and subacute effects of irreversible electroporation on normal common bile ducts in a rabbit model

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