Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer: a novel palliation technique.
Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer: a novel palliation technique.
复制标题
DOI：
10.1155/2013/910897
复制
发表时间：
2013
影响因子：
--
通讯作者：
Kahaleh M
中科院分区：
文献类型：
--
作者：
Figueroa-Barojas P;Bakhru MR;Habib NA;Ellen K;Millman J;Jamal-Kabani A;Gaidhane M;Kahaleh M
目标.放射性消融（RFA）已取代光动力治疗的癌前病变和恶性病变的食管。然而，胆管方面的经验有限。本初步研究的目的是评估射频消融治疗恶性胆管狭窄的安全性和有效性。方法：2010年6月至2012年7月，20例无法切除的恶性胆管狭窄患者接受了RFA和支架置入术。前瞻性记录RFA前后狭窄直径、即刻和30天并发症及支架通畅率。结果共治疗了25例狭窄。平均狭窄长度为15.2 mm（SD = 8.7 mm，范围= 3.5-33 mm）。RFA前狭窄平均直径为1.7 mm（SD = 0.9 mm，范围= 0.5-3.4 mm），而RFA后狭窄平均直径为5.2 mm（SD = 2 mm，范围= 2.6-9 mm）。RFA后胆管直径显著增加3.5 mm（t = 10.8，DF = 24，P值= <.0001）。五名患者在手术后出现疼痛，但只有一名患者发生轻度ERCP后胰腺炎和胆囊炎。结论：放射性消融术是治疗不能切除的恶性胆管狭窄的一种安全的姑息治疗方法。需要一项多中心随机对照试验来证实RFA和支架植入术相较于单独支架植入术的长期受益。
Objectives. Radiofrequency ablation (RFA) has replaced photodynamic therapy for premalignant and malignant lesions of the esophagus. However, there is limited experience in the bile duct. The objective of this pilot study was to assess the safety and efficacy of RFA in malignant biliary strictures. Methods: Twenty patients with unresectable malignant biliary strictures underwent RFA with stenting between June 2010 and July 2012. Diameters of the stricture before and after RFA, immediate and 30 day complications and stent patency were recorded prospectively. Results. A total of 25 strictures were treated. Mean stricture length treated was 15.2 mm (SD = 8.7 mm, Range = 3.5–33 mm). Mean stricture diameter before RFA was 1.7 mm (SD = 0.9 mm, Range = 0.5–3.4 mm) while the mean diameter after RFA was 5.2 mm (SD = 2 mm, Range = 2.6–9 mm). There was a significant increase of 3.5 mm (t = 10.8, DF = 24, P value = <.0001) in the bile duct diameter post RFA. Five patients presented with pain after the procedure, but only one developed mild post-ERCP pancreatitis and cholecystitis. Conclusions: Radiofrequency ablation can be a safe palliation option for unresectable malignant biliary strictures. A multicenter randomized controlled trial is required to confirm the long term benefits of RFA and stenting compared to stenting alone.