Controlled swine bile duct ablation with a bipolar radiofrequency catheter

BackgroundRadiofrequency (RF) power is capable of ablation of neoplastic tissue arising from Barrett's esophagus. Endoscopic catheter bipolar RF ablation is a new technique for ablation of neoplastic tissue in the bile duct.ObjectiveTo determine the effect of RF power on bile duct and solid organ histology.DesignNonsurvival animal study.SettingAcademic center.PatientsThis study involved 4 Yorkshire farm swine.InterventionAfter we made a midline laparotomy incision, a bipolar RF catheter was placed with 3 power (5, 7, 10 W) and voltage settings (66, 132, 190 V) in the bile duct and solid organs (liver, spleen, kidney, and pancreas). Gross and histologic examinations were performed.Main Outcome MeasurementsDepth of ablation in the bile duct wall, characteristics of the ablation in the solid organs.ResultsAn endoscopic bipolar RF catheter produced incomplete (bile duct), patchy ablation (pancreas) with 5 watts, intramural (bile duct) or confluent ablation with 7 watts, and transmural (bile duct) ablation at 10 W. The depth of ablation in the bile duct was 0.9 ± 0.3, 1.5 ± 0.2, 2.3 ± 0.6 mm at 5, 7, and 10 W, respectively (analysis of variance; P = .02). Histologic ablation was not achieved in the liver, although gross changes were seen.LimitationsAnimal study, normal bile duct.ConclusionRF energy applied to the bile duct or solid organs resulted in controlled ablation with a linear relationship between the depth of ablation in the bile duct and RF power.