恶性胆管狭窄是胆管狭窄的一种，常在晚期被诊断出来，导致手术切除困难。目前的研究旨在通过评估组织凝固性坏死的程度来评估内生胆道激光治疗的可行性。使用猪胆管组织进行体外和体内内胆道激光治疗，以表征组织对不同治疗条件下的剂量反应：功率水平、照射时间和治疗次数。将532nm激光光源与球囊集成扩散应用器（BDA）结合，通过内窥镜将激光光线传递给组织进行凝固。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。体外肝脏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功率和治疗次数的增加而增加。体外胆管测试表明，通过10 W的BDA辅助激光治疗，每轮持续12 s，可以可靠地得到长度为5.8 ± 1.6 mm，深度为0.6 ± 0.2 mm的CN。体内实验表明，使用BDA进行内窥镜激光治疗可在导管表面产生CN而无穿孔。显微镜检查显示，体内治疗组织中存在密集的炎性细胞浸润和嗜酸性区域。与体外组织相比，体内组织中CN的范围增加了40％，深度增加了120％（长度：8.1 ± 0.7 mm；深度：1.3 ± 0.2 mm）。BDA辅助激光治疗可能是一种可行的内窥镜治疗胆管狭窄的选择，可在胆管周围均匀消融。进一步的体内研究将在大量胆管狭窄发展的猪模型中进行，以考察拟议的内胆道激光治疗在临床转化中的疗效和安全性。© 2023年Wiley Periodicals LLC.

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.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.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.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.© 2023 Wiley Periodicals LLC.