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恶性胆管梗阻的导管内消融治疗

Intraductal ablation therapy for malignant biliary obstruction.

作者信息

Zhang Qiyu, Dong Yanchao, Niu Hongtao

机构信息

Department of Interventional Treatment, First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, Hebei, 066099, China.

出版信息

Langenbecks Arch Surg. 2024 Dec 10;410(1):2. doi: 10.1007/s00423-024-03572-w.

Abstract

BACKGROUND

Malignant biliary obstruction is usually attributed to the enlargement of tumors within or adjacent to the biliary tract, leading to blockage or compression of the bile ducts. Common causes include pancreatic head cancer, bile duct cancer, gallbladder cancer, liver cancer, and metastatic diseases. Most cases have an insidious onset, lack effective early screening methods, and 70% of patients cannot undergo surgical resection, with a 5-year survival rate of about 30%. Therefore, relieving biliary tree obstruction is crucial. Biliary stents often mitigate the obstruction but can be hindered by tumor progression, endothelial hyperplasia, and bile sludge. As a result, new treatment approaches are constantly being explored to improve outcomes for patients with malignant biliary obstruction.

CURRENT SITUATION

One promising technique that has emerged in recent years is radiofrequency ablation (RFA). This innovative method utilizes high-frequency radio waves to generate heat and selectively target tumor cells through localized heating while preserving surrounding healthy tissue. RFA aims to slow tumor growth and enhance biliary stent durability. Studies on endoscopic RFA for malignant biliary obstruction are encouraging. Integrating it with palliative care may better manage symptoms and extend patient quality of life.

CONCLUSION

In conclusion, while malignant biliary obstruction remains a complex medical challenge with limited treatment options available for some patients, ongoing research into innovative techniques like radiofrequency ablation offers hope for better outcomes in the future. It is crucial for healthcare professionals to stay informed about these advancements and continue exploring new ways to enhance patient care in this difficult clinical scenario.

摘要

背景

恶性胆道梗阻通常归因于胆道内或其附近肿瘤的增大,导致胆管阻塞或受压。常见病因包括胰头癌、胆管癌、胆囊癌、肝癌和转移性疾病。大多数病例起病隐匿,缺乏有效的早期筛查方法,70%的患者无法接受手术切除,5年生存率约为30%。因此,解除胆道梗阻至关重要。胆道支架通常可缓解梗阻,但可能会受到肿瘤进展、内皮增生和胆泥的阻碍。因此,人们不断探索新的治疗方法以改善恶性胆道梗阻患者的治疗效果。

现状

近年来出现的一种有前景的技术是射频消融(RFA)。这种创新方法利用高频无线电波产生热量,并通过局部加热选择性地靶向肿瘤细胞,同时保留周围的健康组织。RFA旨在减缓肿瘤生长并提高胆道支架的耐用性。关于内镜下RFA治疗恶性胆道梗阻的研究令人鼓舞。将其与姑息治疗相结合可能更好地控制症状并延长患者的生活质量。

结论

总之,虽然恶性胆道梗阻仍然是一项复杂的医学挑战,一些患者的治疗选择有限,但对射频消融等创新技术的持续研究为未来取得更好的治疗效果带来了希望。医疗保健专业人员了解这些进展并继续探索在这种困难的临床情况下改善患者护理的新方法至关重要。

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