The Preliminary Study Of Percutaneous Intraductal Radiofrequency Ablation For Treatment Of Malignant Obstructive Jaundice (Analysis Of24Cases)

Objective To investigate the percutaneous intraductal radiofrequency ablation inpatients with malignant biliary obstruction:feasibility,safety and preliminaryefficacy.Materials and Methods Twenty-four patients with inoperable malignant biliaryobstruction (including3cases of biliary stent re-blockage,which one case hasbeen in ablation therapy and biliary stent placement,and follow-up period,the stentre-blockage and ablation again) were included. These patients underwentintraductal biliary radiofrequency ablation of their malignant biliarystrictures,procedure details: ablation energy was5~12W, the sigle of ablation was60~120S, ablation average duration was4.66min (1.5~8.5min), the effectiverange of the average ablation5.76cm (4~10cm).Following ablation, they had ametal stent inserted after balloon occlusion import segment, then observing theefficacy, safety and complications.Results Following this intervention,there were no hemorrhage,bile ductperforation, bile leak, or pancreatitis.24patients were successfully completed biliaryradiofrequency ablation:21cases of biliary stent placement,including15casesbefore stent implantation with balloon;one case is not a single line of balloonwithout stent placement;3cases of biliary stent restenosis after ablation (two case ofballoon dilatation).Biliary drainage success rate was100%(24/24);medianfollow-up period was3months (0.5to10months);The1-month，3-mont，4-month,5-month and6-month stent patency was100%(23/23),83%(15/18),60%(9/15),44%(4/9), and43%(3/7);1month survival rate of96%(23/24),3-monthsurvival rate of95%(18/19),5-month survival rate of64%(10/16),7-monthsurvival rate of63%(5/8).In the follow-up period,Of the24patients,12are aliveand12patients are dead with a median survival of144.9(range13–330) days andmedian stent patency of90(range13–210) days.Among the patients who are alive(n=12) the median stent patency was67.5(range30–210) days, whereas thepatients who died (n=12) had a median stent patency of90.7(range13–180) days, including8patients because of cachexia multi-system failure and death, but thetotal bilirubin and other follow-up period showed no increase.Conclusion Percutaneous transhepatic catheter radiofrequency ablation as a newsafe and feasible method of treatment, the short—term outcome is satisfying,however,efficacy remains to be proven in future, randomized, prospective studies.