REFINEMENT OF A TECHNIQUE FOR THERMOCHOLECYSTECTOMY IN AN ANIMAL-MODEL

RATIONALE AND OBJECTIVES. A modification of a thermal ablation system was tested for improved cystic duct occlusion and gallbladder mucosa a blation in an animal model. METHODS. Fourteen domestic swine were incl uded in group 1 with thermal treatment of the cystic duct to 75 degree s C for 15 minutes, followed by heating of the gallbladder lumen with a catheter/heating device to 54 degrees C for 30 minutes. One swine se rved as a control (group 2). A ligature was placed around the cystic d uct without thermal treatment of the cystic duct and with the catheter /heating device placed into the gallbladder for 30 minutes without the rmal treatment. All animals were killed after 3 weeks with histologic examination of the gallbladder, cystic duct, and surrounding organs. R ESULTS. In group 1, technical failure due to catheter clogging occurre d in the first three animals, which were killed immediately. Eleven an imals were treated with a redesigned catheter system. Three weeks afte r treatment, 10 of the 11 animals had complete cystic duct occlusion a nd complete obliteration of the cystic duct mucosa. One of the 11 anim als experienced partial cystic duct ablation. Nine of the 11 treated a nimals experienced complete mucosal ablation of the gallbladder. Five of the 11 animals had no residual lumen, whereas 6 of the 11 had a lum inal volume that averaged 4 mt compared to 35 mt before treatment. In group 2, the control subject had a gallbladder volume of 50 mt and nor mal gallbladder and cystic duct mucosa. CONCLUSIONS. This study demons trates improvement in both cystic duct occlusion and gallbladder mucos a ablation with standardization of the technique for thermocholecystec tomy in an animal model. However, a better system is required to promo te complete obliteration of the gallbladder lumen.