Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early Results |
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Authors: | Malkhaz Mizandari Madhava Pai Feng Xi Vlastimil Valek Andrasina Tomas Pietro Quaretti Rita Golfieri Cristina Mosconi Ao Guokun Charis Kyriakides Robert Dickinson Joanna Nicholls Nagy Habib |
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Affiliation: | 1. Department of Radiology, Tbilisi State Medical University, Tbilisi, Georgia 2. Department of Surgery, Imperial College, London, Hammersmith Hospital Campus, London, W12 0NN, UK 3. Department of Radiology, University Hospital Brno Bohunice, Jihlavka 20, 63900, Brno, Czech Republic 4. Department of Radiology, IRCCS Policlinico San Matteo, Pavia, Italy 5. Department of Radiology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy 6. Department of Radiology, The 309 Hospital of Chinese PLA, Beijing, China 7. Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK 8. EMcision Limited, London, W12 0HS, UK
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Abstract: | Purpose Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. Methods Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. Results Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14–260) days and median stent patency of 84.5 (range 14–260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14–260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38–210) days. Conclusions In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies. |
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