The combination of endoluminal radiofrequency ablation and metal stent implantation for the treatment of malignant biliary stenosis-Randomized study

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ANDRAŠINA Tomáš ROHAN Tomáš PÁNEK Jiří KOVALČÍKOVÁ Petra KUNOVSKÝ Lumír OSTŘÍŽKOVÁ Lenka VÁLEK Vlastimil

Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj European journal of radiology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.sciencedirect.com/science/article/pii/S0720048X21003119?via%3Dihub
Doi http://dx.doi.org/10.1016/j.ejrad.2021.109830
Klíčová slova Endoluminal ablation; Intraductal ablation; Bile duct stenosis; Radiofrequency ablation; Biliary metal stent
Popis Purpose: To analyse whether endobiliary radiofrequency ablation prior metal stent insertion in malignant biliary stenosis show improved survival or stent patency. Methods: 76 patients with histologically proven malignant biliary stenosis have been enrolled in a prospective, randomized study. In control arm, 40 patients underwent self-expandable metal stent insertion. In experimental arm, the endoluminal ablation with a bipolar radiofrequency catheter was performed immediately before stent insertion. A subgroup analysis of cholangiocarcinoma was performed (22 vs 21 patients). The objective of the study was to determine the rate of complications, duration of the stent patency and the survival of patients (Kaplan-Meier analysis). Results: No major complications related to the stent insertion and the endoluminal ablation were found. The mean primary stent patency was 5.2 (95% CI 0.7-12.8) vs 4.8 months (95% CI 0.8-18.2) months (p = 0.79) in control and experimental group, respectively, in the subgroup analysis with cholangiocarcinoma 4.5 (95% CI 0.8-10.3) and 9.6 (95% CI 5.2-11.2) months (p = 0.029). The median survival since the insertion of the stent was 6.8 (95 %CI 3.0-10.6) vs 5.2 (95 %CI 2.4-7.9) months (p = 0.495) and since the initial drainage 9.8 (95 %CI 6.9-12.7) vs 9.1 (95 %CI 5.4-12.7) months (p = 0.720) in the control and experimental arm. Conclusion: Endobiliary radiofrequency ablation prior metal stent insertion showed increased patency rate only in patients with cholangiocarcinoma, on the other hand, no improvement in survival was demonstrated in this randomized clinical study.

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