Xia Ning, Gong Ju, Lu Jian, Chen Zhi-Jin, Zhang Li-Yun, Wang Zhong-Min
Ning Xia, Ju Gong, Jian Lu, Zhi-Jin Chen, Li-Yun Zhang, Zhong-Min Wang, Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China.
World J Gastroenterol. 2017 Mar 14;23(10):1851-1856. doi: 10.3748/wjg.v23.i10.1851.
To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction.
We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter.
Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to follow-up. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 ± 65 μmol/L and 63 ± 29 μmol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients' stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d.
This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.
评估经皮胆管内射频（RF）治疗胆管支架梗阻的新应用的可行性和有效性。
我们专门报告一项回顾性研究，展示经皮胆管内RF治疗胆管支架闭塞患者的结果。共有43例胆管支架梗阻患者接受了EndoHPB导管置入术，并进行经皮胆管内RF以清理支架。在拔除引流导管后，通过胆管造影以及对比增强计算机断层扫描或超声随访来评估支架通畅情况。
术后，43例患者中40例存活，3例死亡，中位生存期为80.5（范围：30 - 243）天。1例患者失访。1例患者在最后一次随访时支架通畅。2例术后35天和44天出现支架堵塞的患者仅接受了经皮肝穿刺引流术。术前和术后胆红素水平分别为128±65μmol/L和63±29μmol/L。未出现相关并发症（出血、胆管穿孔、胆漏或胰腺炎），术后所有患者的支架通畅情况均经胆管造影证实，中位通畅时间为107（范围：12 - 180）天。
这项初步临床研究表明，经皮胆管内RF治疗胆管支架梗阻安全有效，可延长支架通畅时间，不过仍需随机对照试验来证实该方法的有效性。
