Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations

[EN] Introduction Pre-clinical studies suggest that thermal ablation of the main pancreatic duct (TAMPD) is more recommendable than glue for reducing postoperative pancreatic fistula (POPF). Our aims were (1) to analyze the changes in the pancreas of patients after TAMPD and (2) to correlate the cli...

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Autores: Moll, Xavier, Fondevila, Dolors, García Arnás, Felix, Ielpo, Benedetto, Sánchez-Velázquez, Patricia, Grande, Luis, Jaume, Sofia, Radosevic, Aleksandar, Barranco, Luis, Burdio, Fernando, Andaluz, Anna, Pérez, Juan J|||0000-0001-8486-8699, Berjano, Enrique|||0000-0002-3247-2665
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Politècnica de València (UPV)
Repositorio:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Idioma:inglés
OAI Identifier:oai:riunet.upv.es:10251/197135
Acceso en línea:https://riunet.upv.es/handle/10251/197135
Access Level:acceso abierto
Palabra clave:Duct occlusion
Pancreatic duct
Postoperative pancreatic fistula
Thermal ablation
IDEAL recommendations
TECNOLOGIA ELECTRONICA
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spelling Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendationsMoll, XavierFondevila, DolorsGarcía Arnás, FelixIelpo, BenedettoSánchez-Velázquez, PatriciaGrande, LuisJaume, SofiaRadosevic, AleksandarBarranco, LuisBurdio, FernandoAndaluz, AnnaPérez, Juan J|||0000-0001-8486-8699Berjano, Enrique|||0000-0002-3247-2665Duct occlusionPancreatic ductPostoperative pancreatic fistulaThermal ablationIDEAL recommendationsTECNOLOGIA ELECTRONICA[EN] Introduction Pre-clinical studies suggest that thermal ablation of the main pancreatic duct (TAMPD) is more recommendable than glue for reducing postoperative pancreatic fistula (POPF). Our aims were (1) to analyze the changes in the pancreas of patients after TAMPD and (2) to correlate the clinical findings with those obtained from a study on an animal model. Materials and methods A retrospective early feasibility study of a marketed device for a novel clinical application was carried out on a small number of subjects (n = 8) in whom TAMPD was conducted to manage the pancreatic stump after a pancreatectoduodenectomy (PD). Morphological changes in the remaining pancreas were assessed by computed tomography for 365 days after TAMPD. Results All the patients showed either Grade A or B POPF, which generally resolved within the first 30 days. The duct's maximum diameter significantly increased after TAMPD from 1.5 +/- 0.8 mm to 8.6 +/- 2.9 mm after 7 days (p = .025) and was then reduced to 2.6 +/- 0.8 mm after 365 days PO (p < .0001). The animal model suggests that TAMPD induces dilation of the duct lumen by enzymatic digestion of ablated tissue after a few days and complete exocrine atrophy after a few weeks. Conclusions TAMPD leads to long-term exocrine pancreatic atrophy by completely occluding the duct. However, the ductal dilatation that occurred soon after TAMPD could even favor POPF, which suggests that TAMPD should be conducted several weeks before PD, ideally by digestive endoscopy.Spanish Ministerio de Ciencia, Innovación y Universidades/AgenciaEstatal de Investigación (MCIN/AEI/10.13039/501100011033) under grants RTI2018-094357-B-C21 and RTI2018-094357-B-C22.Taylor & FrancisDepartamento de Ingeniería ElectrónicaEscuela Técnica Superior de Ingeniería Aeroespacial y Diseño IndustrialEscuela Técnica Superior de Ingeniería IndustrialBiosignals & Minimally Invasive Technologies-BioMITAGENCIA ESTATAL DE INVESTIGACIONAgencia Estatal de InvestigaciónRepositorio Institucional de la Universitat Politècnica de València Riunet20232023-12-31journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://riunet.upv.es/handle/10251/197135reponame:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valénciainstname:Universitat Politècnica de València (UPV)InglésengAgencia Estatal de Investigación http://dx.doi.org/10.13039/501100011033 Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 RTI2018-094357-B-C21 MODELADO Y EXPERIMENTACION PARA TERAPIAS ABLATIVAS INNOVADORASAgencia Estatal de Investigación http://dx.doi.org/10.13039/501100011033 Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 RTI2018-094357-B-C22 INVESTIGACION QUIRURGICA PARA TERAPIAS ABLATIVAS INNOVADORASopen accesshttp://purl.org/coar/access_right/c_abf2Reserva de todos los derechoshttp://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/openAccessoai:riunet.upv.es:10251/1971352026-06-13T07:49:27Z
dc.title.none.fl_str_mv Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
title Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
spellingShingle Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
Moll, Xavier
Duct occlusion
Pancreatic duct
Postoperative pancreatic fistula
Thermal ablation
IDEAL recommendations
TECNOLOGIA ELECTRONICA
title_short Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
title_full Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
title_fullStr Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
title_full_unstemmed Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
title_sort Is occlusion of the main pancreatic duct by thermal ablation really safe? A surgical innovation assessed according to IDEAL recommendations
dc.creator.none.fl_str_mv Moll, Xavier
Fondevila, Dolors
García Arnás, Felix
Ielpo, Benedetto
Sánchez-Velázquez, Patricia
Grande, Luis
Jaume, Sofia
Radosevic, Aleksandar
Barranco, Luis
Burdio, Fernando
Andaluz, Anna
Pérez, Juan J|||0000-0001-8486-8699
Berjano, Enrique|||0000-0002-3247-2665
author Moll, Xavier
author_facet Moll, Xavier
Fondevila, Dolors
García Arnás, Felix
Ielpo, Benedetto
Sánchez-Velázquez, Patricia
Grande, Luis
Jaume, Sofia
Radosevic, Aleksandar
Barranco, Luis
Burdio, Fernando
Andaluz, Anna
Pérez, Juan J|||0000-0001-8486-8699
Berjano, Enrique|||0000-0002-3247-2665
author_role author
author2 Fondevila, Dolors
García Arnás, Felix
Ielpo, Benedetto
Sánchez-Velázquez, Patricia
Grande, Luis
Jaume, Sofia
Radosevic, Aleksandar
Barranco, Luis
Burdio, Fernando
Andaluz, Anna
Pérez, Juan J|||0000-0001-8486-8699
Berjano, Enrique|||0000-0002-3247-2665
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Departamento de Ingeniería Electrónica
Escuela Técnica Superior de Ingeniería Aeroespacial y Diseño Industrial
Escuela Técnica Superior de Ingeniería Industrial
Biosignals & Minimally Invasive Technologies-BioMIT
AGENCIA ESTATAL DE INVESTIGACION
Agencia Estatal de Investigación
Repositorio Institucional de la Universitat Politècnica de València Riunet
dc.subject.none.fl_str_mv Duct occlusion
Pancreatic duct
Postoperative pancreatic fistula
Thermal ablation
IDEAL recommendations
TECNOLOGIA ELECTRONICA
topic Duct occlusion
Pancreatic duct
Postoperative pancreatic fistula
Thermal ablation
IDEAL recommendations
TECNOLOGIA ELECTRONICA
description [EN] Introduction Pre-clinical studies suggest that thermal ablation of the main pancreatic duct (TAMPD) is more recommendable than glue for reducing postoperative pancreatic fistula (POPF). Our aims were (1) to analyze the changes in the pancreas of patients after TAMPD and (2) to correlate the clinical findings with those obtained from a study on an animal model. Materials and methods A retrospective early feasibility study of a marketed device for a novel clinical application was carried out on a small number of subjects (n = 8) in whom TAMPD was conducted to manage the pancreatic stump after a pancreatectoduodenectomy (PD). Morphological changes in the remaining pancreas were assessed by computed tomography for 365 days after TAMPD. Results All the patients showed either Grade A or B POPF, which generally resolved within the first 30 days. The duct's maximum diameter significantly increased after TAMPD from 1.5 +/- 0.8 mm to 8.6 +/- 2.9 mm after 7 days (p = .025) and was then reduced to 2.6 +/- 0.8 mm after 365 days PO (p < .0001). The animal model suggests that TAMPD induces dilation of the duct lumen by enzymatic digestion of ablated tissue after a few days and complete exocrine atrophy after a few weeks. Conclusions TAMPD leads to long-term exocrine pancreatic atrophy by completely occluding the duct. However, the ductal dilatation that occurred soon after TAMPD could even favor POPF, which suggests that TAMPD should be conducted several weeks before PD, ideally by digestive endoscopy.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-12-31
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://riunet.upv.es/handle/10251/197135
url https://riunet.upv.es/handle/10251/197135
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Agencia Estatal de Investigación http://dx.doi.org/10.13039/501100011033 Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 RTI2018-094357-B-C21 MODELADO Y EXPERIMENTACION PARA TERAPIAS ABLATIVAS INNOVADORAS
Agencia Estatal de Investigación http://dx.doi.org/10.13039/501100011033 Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 RTI2018-094357-B-C22 INVESTIGACION QUIRURGICA PARA TERAPIAS ABLATIVAS INNOVADORAS
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Reserva de todos los derechos
http://rightsstatements.org/vocab/InC/1.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Reserva de todos los derechos
http://rightsstatements.org/vocab/InC/1.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Taylor & Francis
publisher.none.fl_str_mv Taylor & Francis
dc.source.none.fl_str_mv reponame:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
instname:Universitat Politècnica de València (UPV)
instname_str Universitat Politècnica de València (UPV)
reponame_str RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
collection RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301603

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