Endobiliary radiofrequency ablation combined with bilateral metal stent placement for malignant hilar biliary obstruction
Endobiliary radiofrequency ablation combined with bilateral metal stent placement for malignant hilar biliary obstruction
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DOI：
10.1055/a-1133-4448
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发表时间：
2020-07-01
期刊：
影响因子：
9.3
通讯作者：
Yoneda, Masashi
中科院分区：
文献类型：
--
作者：
Inoue, Tadahisa;Ibusuki, Mayu;Yoneda, Masashi
背景胆管内射频消融（RFA）的有效性仍不确定，特别是在恶性肝门胆管梗阻（MHBO）患者中。我们研究了胆管内射频消融术的疗效，然后通过双边自膨胀金属支架（SEMS）放置不可切除的MHBO。方法41例患者符合研究纳入的资格标准。我们评估了技术成功率、功能成功率和与双侧SEMS置入RFA相关的复发性胆道梗阻（RBO）。RBO发生率为38.5%（15/39），中位RBO时间为230天。在多变量分析中，骨折长度与至RBO的时间呈正相关（P = 0.03）。狭窄长度> 15 mm的患者的RBO中位时间显著长于狭窄长度= 15 mm的患者（314 vs. 156天; P = 0.02）。结论本研究表明，双侧SEMS放置的胆管内RFA取得了良好的结果，但可能需要选择具有适当狭窄长度的患者以获得足够的消融效果。
Background The effectiveness of endobiliary radio-frequency ablation (RFA) is still uncertain, especially in patients with malignant hilar biliary obstruction (MHBO). We examined the efficacy of endobiliary RFA followed by bilateral self-expandable metal stent (SEMS) placement for unresectable MHBO.Methods 41 patients met the eligibility criteria for study inclusion. We evaluated the technical success, functional success, and recurrent biliary obstruction (RBO) associated with RFA with bilateral SEMS placement.Results The technical and functional success rates were both 95.1% (39/41). The RBO rate was 38.5% (15/39), and the median time to RBO was 230 days. Stricture length was positively correlated with time to RBO in the multivariate analysis (P = 0.03). The median time to RBO was significantly longer in patients with strictures > 15mm in length than in those with strictures = 15mm (314 vs. 156 days; P = 0.02).Conclusions The present study showed that endobiliary RFA with bilateral SEMS placement achieved good results, but selection of patients with an appropriate stricture length may be needed to obtain a sufficient ablative effect.