Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct

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• dc.contributor.author Ewertowska, Elżbieta
• dc.contributor.author Andaluz, Anna
• dc.contributor.author Moll, Xavier
• dc.contributor.author Aguilar, Adrià
• dc.contributor.author Garcia, Felix
• dc.contributor.author Fondevila, Dolors
• dc.contributor.author Quesada Diez, Rita
• dc.contributor.author Trujillo Guillén, Macarena
• dc.contributor.author Burdío Pinilla, Fernando
• dc.contributor.author Berjano, Enrique J.
• dc.date.accessioned 2020-01-31T08:19:06Z
• dc.date.available 2020-01-31T08:19:06Z
• dc.date.issued 2019
• dc.description.abstract introduction: Endoluminal sealing of the pancreatic duct by glue or sutures facilitates the management of the pancreatic stump. Our objective was to develop a catheter-based alternative for endoluminal radiofrequency (RF) sealing of the pancreatic duct. Materials and methods: We devised a novel RF ablation technique based on impedance-guided catheter pullback. First, bench tests were performed on ex vivo models to tune up the technique before the in vivo study, after which endoluminal RF sealing of a ∼10 cm non-transected pancreatic duct was conducted on porcine models using a 3 Fr catheter. After 30 days, sealing effectiveness was assessed by a permeability test and a histological analysis. Results: The RF technique was feasible in all cases and delivered ∼5 W of power on an initial impedance of 308 ± 60 Ω. Electrical impedance evolution was similar in all cases and provided guidance for modulating the pullback speed to avoid tissue sticking and achieve a continuous lesion. During the follow-up the animals rate of weight gain was significantly reduced (p < 0.05). Apart from signs of exocrine atrophy, no other postoperative complications were found. At necropsy, the permeability test failed and the catheter could not be reintroduced endoluminally, confirming that sealing had been successful. The histological analysis revealed a homogeneous exocrine atrophy along the ablated segment in all the animals. Conclusions: Catheter-based RF ablation could be used effectively and safely for endoluminal sealing of the pancreatic duct. The findings suggest that a fully continuous lesion may not be required to obtain complete exocrine atrophy.
• dc.description.sponsorship This work was supported by the Spanish Ministerio de Economía, Industria y Competitividad under “Plan Estatal de Investigación, Desarrollo e Innovación Orientada a los Retos de la Sociedad” (Grant TEC2014–52383–C3–R) and by the Spanish Ministerio de Ciencia, Innovación y Universidades under “Programa Estatal de I + D + i Orientada a los Retos de la Sociedad" (Grant: RTI2018-094357-B-C21 and –C22). Elżbieta Ewertowska has a Predoctoral Grant (BES-2015–073285) from the Ministry of Economy, Industry and Competitiveness (Government of Spain). Also funding was received from Secretaría de Estado de Investigación, Desarrollo e Innovación.
• dc.format.mimetype application/pdf
• dc.identifier.citation Ewertowska E, Andaluz A, Moll X, Aguilar A, Garcia F, Fondevila D et al. Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct. Int J Hyperthermia. 2019;36(1):677-86. DOI: 10.1080/02656736.2019.1627585
• dc.identifier.doi http://dx.doi.org/10.1080/02656736.2019.1627585
• dc.identifier.issn 0265-6736
• dc.identifier.uri http://hdl.handle.net/10230/43457
• dc.language.iso eng
• dc.publisher Taylor & Francis
• dc.relation.ispartof International Journal of Hyperthermia. 2019;36(1):677-86
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/TEC2014-52383-C3-R
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C21
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C22
• dc.rights © 2019 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.title Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion