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An evaluation of the protective effect of an infusion of chilled glucose solution on thermal injury of the bile ducts caused by radiofrequency ablation of the liver1 1 Research performed at Laboratory Center for Surgery Trials and Training (CETEC), Albert Einstein Israelite Hospital, and Division of Surgical Gastroenterology, Department of Surgery, Federal University of Sao Paulo (UNIFESP), Brazil. Part of Master degree thesis, Postgraduate Program in Interdisciplinary Surgical Sciences, UNIFESP. Tutor: Marcelo Moura Linhares.

PURPOSE:

To evaluate the protective effects of chilling the bile ducts with cold (5°C) 5% glucose solution (GS) during radiofrequency (RF) administration.

METHODS:

Twenty male pigs (3 mos. old; 25-30 kg) were subjected to RF delivery with chilling (experimental group, N=10) or without chilling (control group, N=10). Half of the animals in each group were euthanized immediately after the operation, and half were euthanized one week later. The following histological variables in relation to the bile ducts were evaluated by a pathologist (blind examiner): degenerative changes to the epithelium; epithelial necrosis; ulceration, regenerative changes of the epithelium; polymorphonuclear neutrophil infiltration; and thermal effects.

RESULTS:

The experimental group (88 bile ducts examined) showed reduced thermal damage relative to the control group (86 bile ducts examined) as demonstrated by significant differences in the following histopathological parameters: epithelial detachment of biliary epithelium (84.1% vs. 59.3%; p<0.006); elongation/palisade arrangement of nuclei (65.1% vs. 87.5%; p<0.001); pseudo-goblet cells (32.9% vs. 56.8%; p<0.001).

CONCLUSION:

Infusion of 5% glucose solution (5°C) has a protective effect on bile ducts subjected to heat (95-110°C, 12 min) from radiofrequency thermal ablation device.

Catheter Ablation; Radio Waves; Cold Temperature; Common Bile Duct; Liver; Intraoperative Period; Swine


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