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Prevention of benign stenosis due to endoluminal irreversible electroporation in bile ducts

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ANDRAŠINA Tomáš PÁNEK Jiří ČERVINKA Dalibor SVOBODOVÁ Iva ROHAN Tomáš HUSTÝ Jakub MARTIN Hiroko VÁLEK Vlastimil

Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

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Popis Purpose To evaluate the possibility of preventing the formation of benign stenosis in healthy bile ducts due to endoluminal irreversible electroporation (IRE). Material and methods Endoluminal IRE of the common bile duct was performed on 15 porcine models using an endoluminal device inserted during laparotomy. The IRE procedure was conducted with 90 pulses of 900-1500 V. Models categorized in group A (n=5) underwent insertion of a biodegradable stent (30x10 mm, Ella-CS) in the ablation site. In group B, the ablation site of the models (n=10) remained untreated. All pigs were euthanized 22 days post-procedure. Biochemical liver tests and MRI were employed for follow-up on days 0, 3, and 22 after ablation. Results The IRE treatment and stent implantation was successful in all procedures. All animals survived over the defined study period. All biodegradable stents remained in place of ablation until the time of autopsy. In group A, serum bilirubin levels were slightly elevated immediately after the procedure (average 19.08 µmol/l compared to 8.33 µmol/l in group B). On day 22, significant elevation of serum bilirubin levels and AST levels were observed in group B (mean 1.73 µmol/l and 18.28 µmol/l, 0.79 µkat/l and 1.74 µkat/l in groups A and B respectively, p<0,05). MRCP sequence on day 22 showed mild or severe dilatation of intrahepatic biliary ducts in a majority of the models (n=9, 90%) in group B. By comparison, the image analysis in group A revealed no intrahepatic dilatation. Conclusion The preventive implantation of biodegradable stents following IRE of bile ducts should be a promising technique to deal with benign stenosis formation after treatment.
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