Yildirim Gulsah, Karakas Hakki Muammer
Department of Radiology, Istanbul Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Turkey.
Pol J Radiol. 2022 Aug 31;87:e487-e493. doi: 10.5114/pjr.2022.119218. eCollection 2022.
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.
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.
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).
Percutaneous temperature-controlled EB-RFA combined with biliary stent placement for malignant biliary obstruction can be safe and feasible, and effectively increase stent patency.
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。
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。
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)。
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。