Clinical study of percutaneous intraductal radiofrequency ablation plus biliary stenting for malignant biliary obstruction

Abstract

Objective To investigate the safety and feasibility of percutaneous intraductal radiofrequency ablation(RFA) plus biliary stenting in the treatment of malignant biliary obstruction. Methods Thirteen patients with unresectable malignant obstructive jaundice were selected, then underwent percutaneus intraductal radiofrequency ablation plus metallic biliary stent placement. Clinical efficacy was evaluated by observing the operative complications, remission of jaundice, and the stent patency and survival rate at 1,3,6 months were recorded. Results All the patients underwent the intraductal RFA . No complications such as perforation, biliary leakage or bile peritonitis occurred. Serum total bilirubin was statistical significantly decreased in 1 week[195.4±83.0)μmol/L vs (196.4±148.4)μmol/L, t=5.156, P<0.01], and the jaundice remission rate was 61.5%. The 1,3 month patency rate was 100%, the 6 month patency rate was 80% (8/10). The 1 month survival rate was 100%, The 3,6 month survival rate was 92% (12/13) and 77% (10/13) respectively. Two patients dead of serious drain with advanced tumors in 65,132 days after operation respectively, and one patient dead of disseminated intravascular coagulation in 97 days. Jaundice recurrence occurred in two patients in 4~5 months after the procedure were controlled after received the interventional treatment again. Conclusions Percutaneous intraductal radiofrequency ablation(RFA) can effectively and safely prolong the stent patency and survival time of patients with malignant biliary obstruction, although its long-term efficacy needs to be further proved. Key words: Radiofrequency ablation; Stent; Interventional treatment; Malignant biliary obstruction