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

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 a...

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Autores: Ewertowska, Elżbieta, Andaluz, Anna, Moll, Xavier, Aguilar, Adrià, Garcia, Felix, Fondevila, Dolors, Quesada Diez, Rita, Trujillo Guillén, Macarena, Burdío Pinilla, Fernando, Berjano, Enrique J.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/43457
Acceso en línea:http://hdl.handle.net/10230/43457
http://dx.doi.org/10.1080/02656736.2019.1627585
Access Level:acceso abierto
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spelling Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic ductEwertowska, ElżbietaAndaluz, AnnaMoll, XavierAguilar, AdriàGarcia, FelixFondevila, DolorsQuesada Diez, RitaTrujillo Guillén, MacarenaBurdío Pinilla, FernandoBerjano, Enrique J.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.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.Taylor & Francis202020202019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/43457http://dx.doi.org/10.1080/02656736.2019.1627585reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésInternational Journal of Hyperthermia. 2019;36(1):677-86info:eu-repo/grantAgreement/ES/1PE/TEC2014-52383-C3-Rinfo:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C21info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C22© 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.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/434572026-06-12T07:21:37Z
dc.title.none.fl_str_mv Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
title Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
spellingShingle Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
Ewertowska, Elżbieta
title_short Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
title_full Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
title_fullStr Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
title_full_unstemmed Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
title_sort Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct
dc.creator.none.fl_str_mv Ewertowska, Elżbieta
Andaluz, Anna
Moll, Xavier
Aguilar, Adrià
Garcia, Felix
Fondevila, Dolors
Quesada Diez, Rita
Trujillo Guillén, Macarena
Burdío Pinilla, Fernando
Berjano, Enrique J.
author Ewertowska, Elżbieta
author_facet Ewertowska, Elżbieta
Andaluz, Anna
Moll, Xavier
Aguilar, Adrià
Garcia, Felix
Fondevila, Dolors
Quesada Diez, Rita
Trujillo Guillén, Macarena
Burdío Pinilla, Fernando
Berjano, Enrique J.
author_role author
author2 Andaluz, Anna
Moll, Xavier
Aguilar, Adrià
Garcia, Felix
Fondevila, Dolors
Quesada Diez, Rita
Trujillo Guillén, Macarena
Burdío Pinilla, Fernando
Berjano, Enrique J.
author2_role author
author
author
author
author
author
author
author
author
description 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.
publishDate 2019
dc.date.none.fl_str_mv 2019
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/43457
http://dx.doi.org/10.1080/02656736.2019.1627585
url http://hdl.handle.net/10230/43457
http://dx.doi.org/10.1080/02656736.2019.1627585
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Hyperthermia. 2019;36(1):677-86
info:eu-repo/grantAgreement/ES/1PE/TEC2014-52383-C3-R
info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C21
info:eu-repo/grantAgreement/ES/2PE/RTI2018-094357-B-C22
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Taylor & Francis
publisher.none.fl_str_mv Taylor & Francis
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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