Abstract
PurposeTo assess the feasibility and safety of percutaneous intraductal radiofrequency ablation (RFA) for unresectable Bismuth types III and IV hilar cholangiocarcinoma.ResultsPercutaneous intraductal RFA combined with metal stent placement was successful in all patients without any technical problems; the technical success rate was 100%. Chemotherapy was administered to two patients. After treatment, serum direct bilirubin levels were notably decreased. Six patients died during the follow-up period. Median stent patency from the time of the first RFA and survival from the time of diagnosis were 100 days (95% confidence interval (CI), 85–115 days) and 5.3 months (95% CI, 2.5–8.1 months), respectively. No acute pancreatitis, bile duct bleeding and perforation, bile leakage, or other severe complications occurred. Four cases of procedure-related cholangitis, three cases of postoperative abdominal pain, and five cases of asymptomatic transient increase in serum amylase were observed. One patient who presented with stent blockage 252 days' post-procedure underwent repeat ablation.Materials and MethodsBetween September 2013 and May 2015, nine patients with unresectable Bismuth types III and IV hilar cholangiocarcinoma who were treated with percutaneous intraductal RFA combined with metal stent placement after the percutaneous transhepatic cholangial drainage were included in the retrospective analysis. Procedure-related complications, stent patency, and survival after treatment were investigated.ConclusionPercutaneous intraductal RFA combined with metal stent placement is a technically safe and feasible therapeutic option for the palliative treatment of unresectable Bismuth types III and IV hilar cholangiocarcinoma. Its long-term efficacy and safety is promising, but needs further study via randomized and prospective trials that include a greater number of patients.
Highlights
Hilar cholangiocarcinoma (Hi CC), called perihilar cholangiocarcinoma or Klatskin tumor, is a common malignant tumor of the biliary tree with about 40%-60% of all cholangiocarcinoma cases [1, 2]
Percutaneous intraductal radiofrequency ablation (RFA) combined with metal stent placement was successful in all patients without any technical problems; the technical success rate was 100%
Materials and Methods: Between September 2013 and May 2015, nine patients with unresectable Bismuth types III and IV hilar cholangiocarcinoma who were treated with percutaneous intraductal RFA combined with metal stent placement after the percutaneous transhepatic cholangial drainage were included in the retrospective analysis
Summary
Hilar cholangiocarcinoma (Hi CC), called perihilar cholangiocarcinoma or Klatskin tumor, is a common malignant tumor of the biliary tree with about 40%-60% of all cholangiocarcinoma cases [1, 2]. Radical surgical resection is the only curative treatment, conferring a 5-year survival rate in the range of 20% to 42% [4]. Symptomatic patients are eligible for curative resection, hilar bile duct resection with major liver resection is the standard treatment for Bismuth types III and IV Hi CC[10], which confers a very poor surgical prognosis, often with further complications [11, 12]. For patients with Bismuth types III and IV Hi CC who cannot tolerate or benefit from surgery, the use of percutaneous transhepatic cholangial drainage (PTCD), chemotherapy, radiotherapy, or chemoradiation therapy as palliative treatment can alleviate obstructive symptoms, improving the quality of life and disease-free survival [13,14,15].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call