Endobiliary radiofrequency ablation in malignant biliary strictures: Nonrandomized prospective cohort study Malign biliyer darlıklarda endobiliyer radyofrekans ablasyon: Nonrandomize prospektif kohort çalışması
Turkiye Klinikleri Journal of Medical Sciences, cilt.41, sa.3, ss.280-288, 2021 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 41 Sayı: 3
- Basım Tarihi: 2021
- Doi Numarası: 10.5336/medsci.2021-81408
- Dergi Adı: Turkiye Klinikleri Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Scopus, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.280-288
- Anahtar Kelimeler: Endobiliary radiofrequency ablation, Impedance, Malign biliary obstruction, Stent
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Self-expandable metallic stents are superior to establish and preserve biliary drainage in malignant biliary obstructions. Endobiliary radiofrequency ablation (EB-RFA) is an important adjunct to increase the efficacy and length of the stent patency. This study is on the efficacy and safety of transhepatic EB-RFA and discusses its procedural steps and technical tips for successful implementation. Material and Methods: Clinical and imaging data of eight patients were retrospectively analyzed. The intervention included EB-RFA, stenting, balloon dilatation and temporary internal biliary catheterization of previously untreated cases. The technical efficacy was determined as the percentage of successfully catheterized patients. The short-term clinical efficacy was determined as the comparison of pre-and post-procedural total and direct bilirubin levels. Results: The mean pre-ablation luminal diameter was 2.4±0.7 mm and the mean post-ablation luminal diameter 7.8±2.0 mm. No intraprocedural and 30-day mortality was encountered. Multiple hepatic abscesses developed in a patient who had re-ablation and two others experienced cholangitis. The most common minor complication was abdominal pain. The preprocedural total bilirubin level was 8.39±3.45 and the direct bilirubin level was 6.82±3.11. The postprocedural total bilirubin level at 7th day was 4.10±2.85 and direct bilirubin level was 2.96±2.16. Patients were followed up to 6.5 months after the procedure. The mean patency time was 56 days and the mean survival was 122 days. Conclusion: This study supports previous reports on EB-RFA and shows the safety and the efficacy of the technique and its implementation. Keeping all procedural steps and possible complications in mind, it has a relatively short learning curve.