Efficacy and safety of percutaneous endobilliary radiofrequency ablation with a novel temperature-controlled catheter in malignant biliary strictures.

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Polish Journal of Radiology Pub Date : 2022-08-31 eCollection Date: 2022-01-01 DOI:10.5114/pjr.2022.119218
Gulsah Yildirim, Hakki Muammer Karakas
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Abstract

Purpose: The purpose of this study is to evaluate the efficacy and safety of temperature-controlled endobilliary radio-frequency ablation (EB-RFA) followed by metal stent placement for nonresectable malignant biliary strictures.

Material and methods: From May 2017 to March 2021, 18 patients with malignant biliary obstruction who had undergone percutaneous EB-RFA and stent placement (n = 9) or stent placement only (n = 9) were included in this retrospective study. Outcomes were stent patency, technical and clinical success, overall survival, and 30-day complication rate. Kaplan-Meier and Cox regression analyses were performed to examine the relationship of EB-RFA with stent patency and overall survival.

Results: The clinical and technical success rate for each group was 100%. The median stent patency was 128 days (95% CI: 122.2-133.8) in the EB-RFA group and 86 days (95% CI: 1.2-170.7) in the control group. It was significantly longer in the study group (p = 0.012). The mean overall survival was 267.7 ± 68.5 days (95% CI: 133.3-402.2) in the study group and 239.6 ± 33.9 days (95% CI: 173.1-306.2) in the control group. Log-rank test showed there was not a statistically significant difference in overall survival rates (p = 0.302). There were no major complications and no statistically significant difference in cholangitis rates (p = 0.620).

Conclusions: Percutaneous temperature-controlled EB-RFA combined with biliary stent placement for malignant biliary obstruction can be safe and feasible, and effectively increase stent patency.

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新型温控导管经皮胆道内射频消融治疗恶性胆道狭窄的疗效和安全性。
目的:本研究的目的是评估温度控制的胆道内射频消融(EB-RFA)后金属支架置入术治疗不可切除的恶性胆道狭窄的疗效和安全性。材料与方法:2017年5月至2021年3月,回顾性研究18例经皮EB-RFA合并支架置入或仅支架置入的恶性胆道梗阻患者(n = 9)。结果是支架通畅、技术和临床成功、总生存和30天并发症发生率。Kaplan-Meier和Cox回归分析EB-RFA与支架通畅和总生存期的关系。结果:各组临床及技术成功率均为100%。EB-RFA组中位支架通畅期为128天(95% CI: 122.2-133.8),对照组为86天(95% CI: 1.2-170.7)。研究组的时间明显更长(p = 0.012)。研究组的平均总生存期为267.7±68.5天(95% CI: 133.3 ~ 402.2),对照组的平均总生存期为239.6±33.9天(95% CI: 173.1 ~ 306.2)。Log-rank检验显示两组总生存率差异无统计学意义(p = 0.302)。两组无重大并发症,胆管炎发生率差异无统计学意义(p = 0.620)。结论:经皮控温EB-RFA联合胆道支架置入术治疗恶性胆道梗阻安全可行,可有效增加支架通畅。
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来源期刊
Polish Journal of Radiology
Polish Journal of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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