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DOI: 10.1055/s-0034-1392252
Evaluation of bipolar radiofrequency ablation for occluded self-expandable metal stents in the bile duct: in vivo and in vitro study
Publikationsverlauf
submitted 29. Dezember 2014
accepted after revision 13. April 2015
Publikationsdatum:
25. Juni 2015 (online)
![](https://www.thieme-connect.de/media/endoscopy/201512/lookinside/thumbnails/11816_10-1055-s-0034-1392252-1.jpg)
Background and aims: Endobiliary radiofrequency ablation (RFA) has been used to treat occluded self-expandable metal stents (SEMSs). The aim of this study was to determine the characteristics of bipolar RFA in occluded SEMSs using both in vivo and in vitro models.
Methods: For the in vivo study, uncovered SEMSs were deployed in the bile ducts of three pigs; another pig was used as the control. RFA was performed at 10 W for 90 seconds. The bile duct was examined for histological changes. For the in vitro simulation of tissue ingrowth in SEMSs, RFA at 10 W for 30 seconds was performed on SEMS-occlusion polyacrylamide-gel phantoms.
Results: The ablation depth was markedly reduced in the stented porcine bile duct. RFA of uncovered SEMS-occlusion gel phantoms resulted in early termination of RFA when the coagulated area contacted the SEMS. This phenomenon was not observed in RFA of the covered SEMS-occlusion gel phantoms.
Conclusions: The presence of SEMSs attenuated the effect of bipolar endobiliary RFA. Tumorous tissue outside the SEMS is unlikely to be affected.
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References
- 1 Andersen JR, Sorensen SM, Kruse A et al. Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice. Gut 1989; 30: 1132-1135
- 2 O'Brien S, Hatfield AR, Craig PI et al. A three year follow up of self expanding metal stents in the endoscopic palliation of longterm survivors with malignant biliary obstruction. Gut 1995; 36: 618-621
- 3 Yoon WJ, Lee JK, Lee KH et al. A comparison of covered and uncovered Wallstents for the management of distal malignant biliary obstruction. Gastrointest Endosc 2006; 63: 996-1000
- 4 Yoon WJ, Ryu JK, Lee JW et al. Endoscopic management of occluded metal biliary stents: metal versus 10F plastic stents. World J Gastroenterol 2010; 16: 5347-5352
- 5 Ridtitid W, Rerknimitr R, Janchai A et al. Outcome of second interventions for occluded metallic stents in patients with malignant biliary obstruction. Surg Endosc 2010; 24: 2216-2220
- 6 Steel AW, Postgate AJ, Khorsandi S et al. Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction. Gastrointest Endosc 2011; 73: 149-153
- 7 Dolak W, Schreiber F, Schwaighofer H et al. Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications. Surg Endosc 2014; 28: 854-860
- 8 Strand DS, Cosgrove ND, Patrie JT et al. ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma. Gastrointest Endosc 2014; 80: 794-804
- 9 Mukund A, Arora A, Rajesh S et al. Endobiliary radiofrequency ablation for reopening of occluded biliary stents: a promising technique. J Vasc Interv Radiol 2013; 24: 142-144
- 10 Pai M, Valek V, Tomas A et al. Percutaneous intraductal radiofrequency ablation for clearance of occluded metal stent in malignant biliary obstruction: feasibility and early results. Cardiovasc Intervent Radiol 2014; 37: 235-240
- 11 Rustagi T, Jamidar PA. Intraductal radiofrequency ablation for management of malignant biliary obstruction. Dig Dis Sci 2014; 59: 2635-2641
- 12 McDonald M, Lochhead S, Chopra R et al. Multi-modality tissue-mimicking phantom for thermal therapy. Phys Med Biol 2004; 49: 2767-2778
- 13 Bu-Lin Z, Bing H, Sheng-Li K et al. A polyacrylamide gel phantom for radiofrequency ablation. Int J Hyperthermia 2008; 24: 568-576
- 14 Goldberg SN, Ryan TP, Hahn PF et al. Transluminal radiofrequency tissue ablation with use of metallic stents. J Vasc Interv Radiol 1997; 8: 835-843