Endoscopic intraductal radiofrequency ablation combined with biliary metal stent for biliary malignant tumor

Abstract

Objective To evaluate the safety and efficacy of endoscopic intraductal radiofrequency ablation combined with biliary metal stent and biliary metal stent only for the treatment of biliary malignant tumor. Methods Data of 48 patients with biliary malignant tumor were reviewed. All patients were examined by ERCP for the range of obstruction. Twenty-four patients received combined therapy (combination group), while 24 others received stent placement only (control group). In the combination group, stenotic segments were treated with intraductal radiofrequency ablation, then metal stents were placed into the biliary duct. In the control group, only metal stents were placed. Changes of serum total bilirubin (TB), surgical complications, days of stent patency and median survival time were studied. Results In the combination group, TB level [median (min-max)]was 238.15 μmol/L (22.10-410.70 μmol/L) before treatment and it decreased to 113.40 μmol/L (9.80-243.70 μmol/L) after, while in the control group it was 239.70 μmol/L(112.30-558.50 μmol/L) before and 121.10 μmol/L (52.10-329.30 μmol/L) after respectively, significantly different in both groups (P<0.05). The time of stent patency was 156 days (44-530 days) in the combination group and 110 days (14-462 days) in the control group (P<0.05). The median survival time was 173 days (44-550 days) and 133 days (14-490 days) respectively(P<0.05). Conclusion The combination therapy of endoscopic intraductal radiofrequency ablation with biliary stent is safe and feasible for biliary malignant tumor. It can prolong the duration of stent patency and median survival time as well as improve postoperative survival quality. Key words: Biliary tract neoplasms; Stents; Radiofrequency ablation