Endoluminal RFA for biliary and pancreatic duct malignant block recanalization
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| Rok publikování | 2012 |
| Druh | Konferenční abstrakty |
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| Popis | Purpose Percutaneous intraductal RFA in patients with malignant biliary and Wirsung duct obstruction is presented. Material and Methods 31 patients with biliary (10 pancreatic cancer, 10 cholangiocarcinoma, 7 metastatic invasion, 1 gallbladder cancer, and 3 hepatocellular carcinoma) and 1 patient with Wirsung duct (pancreatic cancer) unresectable malignant block received percutaneous endoluminal RFA: 23 of biliary patients underwent the stent placement after RF and 8 biliary patients had RFA to clear their obstructed metal stent. RFA was performed using 10 Watts of power for 2 minutes using a new 5 Fr (Wirsung duct) or 8 Fr (bile duct) bipolar RF catheter (Habib EndoHPB, EMcision Ltd., London, UK) placed in a blocked area using a guidewire technique, followed by metal stent (MS) placement. Obstructed MS underwent RFA, followed by balloon ductoplasty and ablated tissue and debris conduction into the duodenum. Results Duct patency restoration has been achieved in all cases. 30 biliary patients (96.8%) maintained stent patency as long as they are alive. The mean stent patency was 115.9 64.8 (50 - 240) days. In 1 case of Wirsung duct block recanalization the stent remains patent for 47 days. There was no 30 day mortality, haemorrhage or pancreatitis following RFA. Three complications were observed - mild bile leakage, cholangitis plus hepatic abscess and stent restenosis. Conclusion Percutaneous RFA treatment appears to be safe and effective in the management of inoperable biliary and Wirsung duct block, as well as in clearing obstructed MS. Randomised studies with prolonged follow-up are warranted. |