title: Optimization of the generator settings for endobiliary radiofrequency ablation.
abstract: OBJECTIVE
  To determine the optimal generator settings for endobiliary radiofrequency ablation.
  
  
  METHODS
  Endobiliary radiofrequency ablation was performed in live swine on the ampulla of Vater, the common bile duct and in the hepatic parenchyma. Radiofrequency ablation time, "effect", and power were allowed to vary. The animals were sacrificed two hours after the procedure. Histopathological assessment of the depth of the thermal lesions was performed.
  
  
  RESULTS
  Twenty-five radiofrequency bursts were applied in three swine. In the ampulla of Vater (n = 3), necrosis of the duodenal wall was observed starting with an effect set at 8, power output set at 10 W, and a 30 s shot duration, whereas superficial mucosal damage of up to 350 μm in depth was recorded for an effect set at 8, power output set at 6 W and a 30 s shot duration. In the common bile duct (n = 4), a 1070 μm, safe and efficient ablation was obtained for an effect set at 8, a power output of 8 W, and an ablation time of 30 s. Within the hepatic parenchyma (n = 18), the depth of tissue damage varied from 1620 μm (effect = 8, power = 10 W, ablation time = 15 s) to 4480 μm (effect = 8, power = 8 W, ablation time = 90 s).
  
  
  CONCLUSIONS
  The duration of the catheter application appeared to be the most important parameter influencing the depth of the thermal injury during endobiliary radiofrequency ablation. In healthy swine, the currently recommended settings of the generator may induce severe, supratherapeutic tissue damage in the biliary tree, especially in the high-risk area of the ampulla of Vater.
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Maximilien
authors.initials: M
authors.lastname: Barret
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Leblanc
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Vienne
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Rouquette
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Beuvon
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.affiliation: Maximilien Barret, Sarah Leblanc, Ariane Vienne, Stanislas Chaussade, Frederic Prat, Department of Gastroenterology, Cochin Hospital, 75014 Paris, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Prat
keywords: Ampullary tumor; Biliary stricture; Endobiliary radiofrequency ablation; Endoscopic retrograde cholangio-pancreatography