Document Detail

Minimizing central bile duct injury during radiofrequency ablation: use of intraductal chilled saline perfusion--initial observations from a study in pigs.
MedLine Citation:
PMID:  15220500     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine whether intraductal perfusion with chilled saline reduces thermal injury to bile ducts during radiofrequency (RF) ablation. MATERIALS AND METHODS: In swine, anesthesia was induced and the common bile duct was surgically cannulated with a pediatric feeding tube. RF thermal lesions were created adjacent to bile ducts by using an expandable-hook 2-cm RF electrode and 90-W generator. In three pigs, chilled saline was perfused through the ducts at 1.5 L/h (26 mL/min), and in another pig, room-temperature saline was perfused at the same rate. In three pigs (control group), RF lesions were created without perfusion. After 48 hours, animals were sacrificed. Periductal sections from all animals were reviewed by a liver pathologist. The degree of injury to biliary epithelium and subepithelial glands was assessed on a scale of 0%-100%. Significance of differences between degrees of injury was assessed with the Mann-Whitney test. RESULTS: In the control group, there was a mean of 100% injury to biliary ductal epithelium and 99.3% to subepithelial ductal glands. In the room-temperature saline group, there was a mean of 100% biliary epithelial injury and 84.4% glandular injury. In the chilled saline group, there was a mean of 52.9% ductal epithelial injury and 12.1% subepithelial glandular injury. In comparison with the control group, there was significantly less (P <.05) thermal injury to biliary epithelium in the chilled saline group and to subepithelial glands in both the room-temperature and chilled saline perfusion groups. CONCLUSION: RF-induced bile duct injury may be decreased significantly with an intraductal infusion of chilled saline.
Steven S Raman; Donya Aziz; Xinlian Chang; Ming Ye; James Sayre; Charles Lassman; David S K Lu
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Radiology     Volume:  232     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-28     Completed Date:  2004-07-29     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  154-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2004
Department of Radiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1721, USA.
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MeSH Terms
Bile Ducts, Intrahepatic / injuries*,  pathology
Catheter Ablation / adverse effects,  methods*
Hot Temperature / adverse effects
Liver / surgery*
Sodium Chloride / administration & dosage*
Reg. No./Substance:
7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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