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经皮经肝胆管内射频消融治疗难治性良性胆肠吻合口和胆管狭窄。

Percutaneous endobiliary radiofrequency ablation for refractory benign hepaticojejunostomy and biliary strictures.

机构信息

Department of Interventional Radiology, Turkey Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

Osmangazi University, Faculty of Medicine Department of Interventional Radiology, Eskisehir, Turkey.

出版信息

Diagn Interv Imaging. 2018 Sep;99(9):555-560. doi: 10.1016/j.diii.2018.02.006. Epub 2018 Apr 11.

Abstract

PURPOSE

The objective of this study was to determine the safety and efficacy of percutaneous endobiliary radiofrequency ablation (ERFA) and balloon dilation for the treatment of hepaticojejunostomy (HJ) strictures resistant to surgery and/or other interventions.

MATERIALS AND METHODS

Eighteen patients who underwent percutaneous ERFA for HJ stricture were included. There were 10 men and 8 women with a mean age of 48.3±10.8 (SD) years (range: 33-69 years). The 18 patients had a total of 29 benign HJ strictures secondary to cholecystectomy (14 patients; 78.0%), Whipple procedure (3 patients; 16.6%) or blunt abdominal trauma (1 patient; 5.4%). The different end-points were technical success, clinical success, recurrence, procedure-related mortality, and morbidity.

RESULTS

Technical and clinical success rates were 100% and 83.3%, respectively. No mortality and major procedure-related complications were observed. One patient experienced minor complication (self-limited pleural effusion). Two patients did not show favorable response to ERFA whereas 10 patients had no stricture recurrence during a mean follow-up period of 7.3 months±1.0 (SD) (range: 4-10 months).

CONCLUSION

ERFA is a safe and effective treatment for benign HJ and biliary strictures. However, more studies involving more patients with a long-term follow-up period should be made to fully determine the long-term results of ERFA.

摘要

目的

本研究旨在确定经皮内镜下胆管内射频消融(ERFA)联合球囊扩张治疗手术和/或其他介入治疗抵抗的胆肠吻合口(HJ)狭窄的安全性和有效性。

材料与方法

本研究共纳入 18 例行 ERFA 治疗 HJ 狭窄的患者。其中男性 10 例,女性 8 例,平均年龄 48.3±10.8(SD)岁(范围:33-69 岁)。18 例患者共有 29 条良性 HJ 狭窄,继发于胆囊切除术(14 例;78.0%)、Whipple 手术(3 例;16.6%)或钝性腹部创伤(1 例;5.4%)。不同的终点包括技术成功率、临床成功率、复发率、与操作相关的死亡率和发病率。

结果

技术成功率和临床成功率分别为 100%和 83.3%。无死亡和重大操作相关并发症。1 例患者出现轻微并发症(自限性胸腔积液)。2 例患者对 ERFA 无良好反应,10 例患者在平均 7.3 个月±1.0(SD)(范围:4-10 个月)的随访期间无狭窄复发。

结论

ERFA 是治疗良性 HJ 和胆管狭窄的一种安全有效的方法。然而,需要更多涉及更多患者和长期随访的研究来充分确定 ERFA 的长期结果。

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