The methodology for endoluminal irreversible electroporation in porcine models

The aim of this study was to describe the methodology of the surgical technique for endoluminal irreversible electroporation in the biliary tract performed within the perihilar region in porcine models. Endoluminal irreversible electroporation of the common bile duct was performed on eight porcine models using an endoluminal device inserted during laparotomy. The endoluminal device consisted of three electrodes 1 cm in length, attached at 120 degrees around the balloon catheter. The procedure was conducted with the following parameters: number of pulses 90, voltage of 1500 V between each couple of electrodes. Cross sectional imaging and histopathological assessment were employed for evaluations of the ablation zone. Models were sacrificed 24 h and 96 h after ablation. The treatment was successful in all porcine models. All animals survived the defined study period. Peri-ablation oedema within the hepatoduodenal ligament and adjacent liver tissue could be measured on post-procedural MRI or CT. Perforation in the site of ablation developed in one model. Histopathological examination showed heavy regressive changes of the ablated tissue. The elastic membranes of the adjacent portal vein were preserved in all models. In our experience, this novel endoluminal modality used within the perihilar region in porcine models is a feasible and well predictable procedure. Further studies should explore the optimal protocol of catheter-based ablation to limit complications.