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Percutaneous intraductal radiofrequency ablation combined with biliary stent placement for treatment of malignant biliary obstruction

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the safety and efficacy of percutaneous intraductal radiofrequency ablation (RFA) combined with biliary metal stent placement for patients with unresectable malignant biliary obstruction.

Methods

From a cohort of 70 patients with unresectable malignant biliary obstruction, 28 patients received percutaneous intraductal RFA combined with biliary stent placement (group A) and the remaining 42 were treated with biliary metal stent placement only (group B). Stent patency, overall survival (OS), alleviation of jaundice, and postoperative complications were assessed.

Results

The technical success rate for both groups was 100%. No severe complications (e.g., biliary bleeding, perforation) occurred. In both groups, jaundice was relieved and the decrease of the total and direct bilirubin concentration was significant (p < 0.01). The median time of stent patency in group A and group B were 6.6 ± 0.3 months (95% CI 6.1–7.1 months) and 4.9 ± 0.4 months (95% CI 4.2–5.6 months), respectively (p < 0.01). The median overall survival times in Group A were 7.2 ± 0.3 months (95% CI 6.5–7.9 months) versus 5.6 ± 0.4 months (95% CI 4.8–6.4 months) in group B (p < 0.01). In univariate and multivariate analyses, intraductal RFA, stent patency, and decreased baseline serum direct bilirubin concentration were associated with greater OS (p < 0.05).

Conclusion

Percutaneous intraductal RFA combined with stent placement is a safe and effective method for patients with malignant biliary obstruction. As compared to stent placement alone, percutaneous intraductal RFA can significantly prolong stent patency and improve the overall survival of patients with malignant biliary obstruction.

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Acknowledgements

This work was supported by the Shanghai Municipal Population and Family Planning Commission (201640277) and Natural Science Foundation of Shanghai (19ZR1450800).

Funding

None.

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Author notes

  1. Tianzhu Yu and Wei Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Shanghai, 200032, China

    Tianzhu Yu, Wei Zhang, Changyu Li, Chenggang Wang, Gaoquan Gong, Liangwen Wang, Guoping Li, Yi Chen & Xiaolin Wang

  2. Shanghai Institution of Medical Imaging, Shanghai, China

    Tianzhu Yu, Wei Zhang, Changyu Li, Chenggang Wang, Gaoquan Gong, Liangwen Wang, Guoping Li, Yi Chen & Xiaolin Wang

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  1. Tianzhu Yu
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  2. Wei Zhang
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  3. Changyu Li
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  4. Chenggang Wang
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  5. Gaoquan Gong
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  7. Guoping Li
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  8. Yi Chen
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  9. Xiaolin Wang
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Contributions

Study conception and design by YC; administrative support by XLW; provision of study materials or patients by WZ, CGW, LGP and GQG; collection and assembly of data by TZY, WZ, CYL and LWW; data analysis and interpretation by TZY; manuscript writing by all authors and final approval of manuscript by all authors.

Corresponding authors

Correspondence to Yi Chen or Xiaolin Wang.

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Conflict of interest

the authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee (No. B2016-080, Zhongshan Hospital, Fudan University, China).

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Informed consent was obtained from all individual participants included in the study.

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Yu, T., Zhang, W., Li, C. et al. Percutaneous intraductal radiofrequency ablation combined with biliary stent placement for treatment of malignant biliary obstruction. Abdom Radiol 45, 3690–3697 (2020). https://doi.org/10.1007/s00261-020-02516-4

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  • DOI: https://doi.org/10.1007/s00261-020-02516-4

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