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新型温控导管经皮肝内胆管射频消融治疗恶性胆管狭窄的疗效与安全性

Efficacy and safety of percutaneous endobilliary radiofrequency ablation with a novel temperature-controlled catheter in malignant biliary strictures.

作者信息

Yildirim Gulsah, Karakas Hakki Muammer

机构信息

Department of Radiology, Istanbul Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Turkey.

出版信息

Pol J Radiol. 2022 Aug 31;87:e487-e493. doi: 10.5114/pjr.2022.119218. eCollection 2022.

Abstract

PURPOSE

The purpose of this study is to evaluate the efficacy and safety of temperature-controlled endobilliary radio-frequency ablation (EB-RFA) followed by metal stent placement for nonresectable malignant biliary strictures.

MATERIAL AND METHODS

From May 2017 to March 2021, 18 patients with malignant biliary obstruction who had undergone percutaneous EB-RFA and stent placement ( = 9) or stent placement only ( = 9) were included in this retrospective study. Outcomes were stent patency, technical and clinical success, overall survival, and 30-day complication rate. Kaplan-Meier and Cox regression analyses were performed to examine the relationship of EB-RFA with stent patency and overall survival.

RESULTS

The clinical and technical success rate for each group was 100%. The median stent patency was 128 days (95% CI: 122.2-133.8) in the EB-RFA group and 86 days (95% CI: 1.2-170.7) in the control group. It was significantly longer in the study group ( = 0.012). The mean overall survival was 267.7 ± 68.5 days (95% CI: 133.3-402.2) in the study group and 239.6 ± 33.9 days (95% CI: 173.1-306.2) in the control group. Log-rank test showed there was not a statistically significant difference in overall survival rates ( = 0.302). There were no major complications and no statistically significant difference in cholangitis rates ( = 0.620).

CONCLUSIONS

Percutaneous temperature-controlled EB-RFA combined with biliary stent placement for malignant biliary obstruction can be safe and feasible, and effectively increase stent patency.

摘要

目的

本研究旨在评估温控内镜下胆道射频消融术(EB-RFA)联合金属支架置入术治疗不可切除恶性胆管狭窄的疗效和安全性。

材料与方法

本回顾性研究纳入了2017年5月至2021年3月期间18例接受经皮EB-RFA及支架置入术(n = 9)或仅接受支架置入术(n = 9)的恶性胆管梗阻患者。观察指标包括支架通畅情况、技术及临床成功率、总生存期和30天并发症发生率。采用Kaplan-Meier法和Cox回归分析来检验EB-RFA与支架通畅率及总生存期之间的关系。

结果

每组的临床和技术成功率均为100%。EB-RFA组支架中位通畅时间为128天(95%CI:122.2 - 133.8),对照组为86天(95%CI:1.2 - 170.7)。研究组的支架通畅时间显著更长(P = 0.012)。研究组的平均总生存期为267.7±68.5天(95%CI:133.3 - 402.2),对照组为239.6±33.9天(95%CI:173.1 - 306.2)。对数秩检验显示总生存率无统计学显著差异(P = 0.302)。无严重并发症,胆管炎发生率无统计学显著差异(P = 0.620)。

结论

经皮温控EB-RFA联合胆道支架置入术治疗恶性胆管梗阻安全可行,可有效提高支架通畅率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5aa6/9453241/3ab78c4d1a69/PJR-87-47740-g001.jpg

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