Percutaneous intraductal radiofrequency ablation for treatment of biliary stent occlusion: A preliminary result

• Published in: World journal of gastroenterology : WJG Vol. 23; no. 10; pp. 1851 - 1856
• Main Authors: Xia, Ning, Gong, Ju, Lu, Jian, Chen, Zhi-Jin, Zhang, Li-Yun, Wang, Zhong-Min
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 14-03-2017
• Subjects: Aged; Aged, 80 and over; Bile Duct Neoplasms - blood; Bile Duct Neoplasms - complications; Bile Duct Neoplasms - mortality; Bile Duct Neoplasms - surgery; Bilirubin - blood; Catheter Ablation - adverse effects; Catheter Ablation - methods; Cholestasis - blood; Cholestasis - etiology; Cholestasis - mortality; Cholestasis - surgery; Clinical Trials Study; Feasibility Studies; Female; Humans; Male; Middle Aged; Pilot Projects; Retrospective Studies; Stents - adverse effects; Survival Analysis; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography; Percutaneous transhepatic cholangiography; Intraductal radiofrequency; Malignant obstructive jaundice
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v23.i10.1851

AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency(RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an Endo HPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter.RESULTS Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5(range: 30-243) d. One patient was lost to followup. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 ± 65 μmol/L and 63 ± 29 μmol/L, respectively. There were no related complications(haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients’ stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107(range: 12-180) d.CONCLUSION This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.