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经皮经肝胆道内射频消融联合胆道支架置入治疗恶性胆道梗阻的可行性和安全性。

Feasibility and safety of percutaneous transhepatic endobiliary radiofrequency ablation as an adjunct to biliary stenting in malignant biliary obstruction.

机构信息

Osmangazi university faculty of medicine, department of radiology, Eskisehir 26040, Turkey.

出版信息

Diagn Interv Imaging. 2018 Apr;99(4):237-245. doi: 10.1016/j.diii.2017.10.002. Epub 2017 Nov 2.

Abstract

PURPOSE

The purpose of this study was to investigate the feasibility and safety of percutaneous transhepatic endobiliary radiofrequency ablation (RFA) combined with biliary stenting in palliative treatment of malignant biliary obstructions.

MATERIALS AND METHODS

Twenty-one patients who had undergone percutaneous transhepatic endobiliary RFA as an adjunct to biliary stenting were included. There were 12 men and nine women with a mean age of 67±13.6 (SD) years (range: 34-86 years). Demographic data, procedure details and follow-up data including complications, survival time and stent patency time were documented. The median stent patency time and survival time, as well as the 30- day and 180-day cumulative survival and stent patency rates were estimated using the Kaplan-Meier method.

RESULTS

Twenty-four percutaneous transhepatic endobiliary RFA procedures were performed. There were no procedure-related major complications or death. Three patients who had developed stent reocclusion underwent a second endobiliary RFA, without insertion of a new stent. The most common complications were post-procedural pain and cholangitis. Overall survival and stent patency times ranged between 5-542 days and 5-251 days, respectively. The median survival time was 76 days (95%CI: 0-233 days) and stent patency time was 133 days (95% CI: 25-240 days). The 30- and 180- day cumulative stent patency rates were 75% and 34%, respectively.

CONCLUSION

Percutaneous transhepatic endobiliary RFA is a feasible, safe and cost-effective method in restoration of biliary drainage in patients with malignant biliary obstruction.

摘要

目的

本研究旨在探讨经皮经肝胆道内射频消融(RFA)联合胆道支架置入在恶性胆道梗阻姑息治疗中的可行性和安全性。

材料和方法

共纳入 21 例接受经皮经肝胆道内 RFA 联合胆道支架置入的患者。其中男 12 例,女 9 例,平均年龄 67±13.6(SD)岁(范围:34-86 岁)。记录患者的人口统计学数据、手术细节和随访资料,包括并发症、生存时间和支架通畅时间。采用 Kaplan-Meier 法估计中位支架通畅时间和生存时间,以及 30 天和 180 天的累积生存率和支架通畅率。

结果

共进行了 24 次经皮经肝胆道内 RFA 手术。无与手术相关的严重并发症或死亡。3 例支架再闭塞患者行二次胆道内 RFA,未置入新支架。最常见的并发症是术后疼痛和胆管炎。总生存时间和支架通畅时间为 5-542 天和 5-251 天。中位生存时间为 76 天(95%CI:0-233 天),支架通畅时间为 133 天(95%CI:25-240 天)。30 天和 180 天的累积支架通畅率分别为 75%和 34%。

结论

经皮经肝胆道内射频消融是一种可行、安全且具有成本效益的方法,可恢复恶性胆道梗阻患者的胆道引流。

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