Percutaneous transhepatic cholangiography and intraductal radiofrequency ablation combined with biliary stent placement for malignant biliary obstruction.

Abstract

PURPOSE:

To determine the safety and feasibility of percutaneous transhepatic cholangiography (PTC) and intraductal radiofrequency (RF) ablation combined with biliary stent placement for malignant biliary obstruction.

MATERIALS AND METHODS:

Data from patients with unresectable malignant biliary obstruction who underwent PTC, intraductal RF ablation, and biliary stent placement (n = 12) or PTC and biliary stent placement only (control group; n = 14) were reviewed. Postoperative complications, jaundice remission, and stent patency were assessed.

RESULTS:

All procedures were successful. No severe complications (eg, biliary bleeding, perforation) occurred. Two experimental group patients developed cholangitis, which resolved with conservative treatment. The 1-week jaundice remission and 3-month stent patency rates were similar in both groups, but the 6-month stent patency rate was higher in the experimental group (P < .05). In the experimental group, one death occurred as a result of gastrointestinal hemorrhage (unrelated to stent placement) by 3 months, and there were two cases of recurrent jaundice by 6 months. The latter two patients underwent repeat PTC, ablation, and stent placement. In the control group, one death occurred as a result of hepatic failure caused by progressive jaundice at 3 months, and another death resulted from disseminated intravascular coagulation caused by jaundice recurrence at 138 days after stent placement. In addition, seven patients developed jaundice recurrence (50-151 d after stent placement). PTC and repeat stent placement were performed in these patients.

CONCLUSIONS:

Percutaneous transhepatic cholangiography and intraductal RF ablation combined with biliary stent placement for malignant biliary obstruction is safe and feasible and effectively prolongs stent patency time.

• Authors: Teng-Fei Li, Guo-Hao Huang, Zhen Li, Chang-Fu Hao, Jian-Zhuang Ren, Xu-Hua Duan, Kai Zhang, Chen Chen, Xin-Wei Han, De-Chao Jiao, Meng-Fan Zhang, Yan-Li Wang
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 26 Issue 5 Pg. 715-21 (May 2015) ISSN: 1535-7732 [Electronic] United States
• PMID: 25817458 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Topics

• Bile Duct Neoplasms (complications)
• Catheter Ablation
• Cholangiography (methods)
• Cholestasis (diagnostic imaging, surgery)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Stents
• Treatment Outcome