Balloon-assisted laser application for endoscopic treatment of biliary stricture

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine Pub Date : 2023-09-20 DOI:10.1002/lsm.23726

Seonghee Lim MS, Van Gia Truong PhD, Seok Jeong MD, PhD, Jiho Lee BS, Byeong-il Lee PhD, Hyun Wook Kang PhD

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引用次数: 0

Abstract

Objectives

Malignant biliary stricture is a ductal narrowing of the bile duct that is often diagnosed at an advanced stage, leading to difficulty in resection. The current study aims to evaluate the feasibility of endobiliary laser treatment by quantifying the extent of coagulative necrosis in tissue under various conditions.

Methods

Ex vivo and in vivo porcine bile tissues were used for endobiliary laser treatment to characterize the dosimetric responses of the tissue to various treatment conditions: power level, irradiation time, and number of treatments. 532 nm laser light was coupled with a balloon-integrated diffusing applicator (BDA) to deliver the laser light endoscopically for tissue coagulation. The coagulated regions (maximum length and depth) in the treated tissues were evaluated histologically for quantitative comparison.

Results

Dosimetric evaluations with ex vivo liver tissue confirmed that both maximum length and depth of coagulative necrosis (CN) increased with applied power and number of treatments. Ex vivo bile duct tests demonstrated that BDA-assisted laser treatment at 10 W for 12 s reproducibly yielded CN with a length of 5.8 ± 1.6 mm and a depth of 0.6 ± 0.2 mm. In vivo tests presented that endoscopic laser treatment using the BDA created CN on the ductal surface without any perforation. Microscopic examinations revealed that a dense inflammatory cell infiltration and eosinophilic area in the in vivo treated tissue. The extent of CN in the in vivo tissue was 40% longer and 120% deeper (length: 8.1 ± 0.7 mm; depth: 1.3 ± 0.2 mm), compared to that in the ex vivo tissue.

Conclusion

BDA-assisted laser treatment could be a feasible option for endoscopic treatment of biliary stricture with uniform ablation at the circumference of bile duct. Further in vivo studies will be performed in a large number of stricture-developed porcine models to examine both efficacy and safety of the proposed endobiliary laser treatment for clinical translations.

查看原文本刊更多论文

球囊辅助激光在胆道狭窄内镜治疗中的应用。

目的：恶性胆管狭窄是指胆管狭窄，通常在晚期诊断，导致切除困难。本研究旨在通过量化不同条件下组织凝固性坏死的程度来评估胆道内激光治疗的可行性。方法：使用离体和体内猪胆汁组织进行胆道内激光治疗，以表征组织对各种治疗条件的剂量反应：功率水平、照射时间和治疗次数。532 nm激光与球囊集成扩散施加器（BDA）耦合，以通过内窥镜递送激光用于组织凝固。对治疗组织中的凝固区域（最大长度和深度）进行组织学评估，以进行定量比较。结果：对离体肝组织的剂量评估证实，凝固性坏死（CN）的最大长度和深度随着施加的功率和治疗次数的增加而增加。离体胆管测试表明，BDA在10 W代表12 s可重复产生长度为5.8的CN ± 1.6 mm，深度0.6 ± 0.2 体内测试表明，使用BDA的内窥镜激光治疗在导管表面产生CN，没有任何穿孔。显微镜检查显示，在体内处理的组织中有致密的炎症细胞浸润和嗜酸性粒细胞区域。体内组织中CN的范围长40%，深120%（长度：8.1 ± 0.7 mm；深度：1.3 ± 0.2 mm）。结论：BDA辅助激光治疗胆管狭窄是一种可行的内镜下胆管周围均匀消融治疗方法。将在大量开发的狭窄猪模型中进行进一步的体内研究，以检查拟议的胆道内激光治疗临床转化的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.

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