Analysis Of The Clinical Effect Of Percutaneous Intraluminal Radiofrequency Ablation Combined With Biliary Stenting And Biliary Stenting Only In The Treatment Of Malignant Obstructive Jaundice

Objective: To compare the clinical effect of percutaneous intraluminal radiofrequency ablation(RFA) combined with biliary stenting and biliary stenting only in the treatment of malignant obstructive jaundice.Methods: A total of 56 patients with unresectable malignant obstructive jaundice were reviewed retrospectively, among which 25 patients had percutaneous intraluminal RFA combined with biliary stenting(RFA group);while simultaneously 31 patients were selected for the simple biliary stent implantation(stent group). The changes of the serum total bilirubin(TB) and indirect bilirubin(DB) were observed preoperation and 7-14 days postoperation. surgical complications, stent median patency and the median survival were compared in these two groups. Follow-up information was obtained through telephone review or check-up records.Results: The technical success rate was 100%. No procedure-related peritonitis, perforating occurred. 3 cases had biliary tract infect in RFA group and stent group respectively, who were cured by antibiotics and lavage of tube. There were 1 cases with a small amount of bleeding in RFA group and 1 cases with a small amount of bleeding in stent group. All the cases were controlled by coagulatory drugs and resting in bed. TB was(264.99±153.39)umol/L and DB was(187.47±111.85)umol/L before treatment in RFA group, TB was(115.94±99.45)umol/L and DB was(90.54±76.69)umol/L 7~140d after treatment in RFA group, There were obvious statistical significances before and 7~14 days after treatment in TB and DB in RFA group(P<0.01; P<0.01); TB was(224.41±129.30)umol/L and DB was(150.60±90.45)umol/L before treatment in stent group, TB was TB(73.01±49.16)umol/L and DB was(56.39±39.20)umol/L 7 ~ 14 d after treatment in stent group, There were obvious statistical significances before and 7~14 days after treatment in TB and DB in RFA group( P<0.01; P<0.01). TB and DB fell by(149.05±110.71)umol/L and(96.93±69.12) umol/L after 7~14 days in RFA group. TB and DB fell by(151.40±94.47)umol/L and(94.21±67.36) umol/L after 7~14 days in stent group. The changes of two groups had no statistical significances(P=0.942; P=0.899). The stent patencys were 122d(9d~550d) and 157d(16d~510d), while the median survival were 125d(9d~550d) and 163d(16d~520d) in RFA group and stent group, the difference of two groups was of no statistical significance(p=0.256;p=0.224).Conclusions: Percutaneous intraluminal RFA combined with biliary stenting and biliary stenting only both were safe and feasible therapeutic options for unresectable malignant obstructive jaundice. The effect of these two options showed no difference statistically in the short and long term. This result is different from the anticipation that should live longer, so in the future study we should make further stratificantion in selecting patients in order to make clear that percutaneous intraluminal radiofrequency ablation combined with biliary stenting and biliary stenting only have different results in different malignant obstructive jaundice.