Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical College, New York, NY 10021, USA.
J Oncol. 2013;2013:910897. doi: 10.1155/2013/910897. Epub 2013 Apr 8.
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.
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.
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.
射频消融术（RFA）已取代光动力疗法，用于治疗食管的癌前病变和恶性病变。然而，胆管内的应用经验有限。本研究旨在评估 RFA 治疗恶性胆管狭窄的安全性和疗效。
2010 年 6 月至 2012 年 7 月，20 例不可切除的恶性胆管狭窄患者接受了 RFA 联合支架置入术。前瞻性记录 RFA 前后胆管狭窄的直径、即刻和 30 天并发症以及支架通畅情况。
共治疗了 25 处狭窄。治疗的狭窄总长度为 15.2mm（标准差[SD]=8.7mm，范围=3.5-33mm）。RFA 前狭窄直径平均为 1.7mm（SD=0.9mm，范围=0.5-3.4mm），RFA 后平均直径为 5.2mm（SD=2mm，范围=2.6-9mm）。RFA 后胆管直径显著增加 3.5mm（t=10.8，自由度[DF]=24，P 值＜.0001）。术后 5 例患者出现疼痛，但仅 1 例发生轻度内镜逆行胰胆管造影术后胰腺炎和胆囊炎。
RFA 是治疗不可切除的恶性胆管狭窄的一种安全姑息治疗方法。需要进行多中心随机对照试验，以确认与单独支架置入相比，RFA 联合支架置入的长期获益。
