Endoluminal radiofrequency ablation treatment of maiignant biliary stenosis via percutaneous transhepatic approach

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey

Approval Date: 2015




Endoluminal radiofrequency ablation (RFA) is a promising palliative treatment of malignant biliary stenosis applicable by endoscopic or percutaneous route. The aim of this study is to evaluate the clinical feasibility and safety of percutaneosly applied endoluminal RFA of malignant biliary stenosis. Thirty-one patients with inoperable malignant biliary stenosis were included. These patients underwent percutaneous endoluminal RFA after biliary decompression with an internal external or external drainage. Following 30 of 32 ablations, a metal stent was inserted. The main pathological diagnosis was pancreatic cancer (n=24) in our patient group. All the 32 ablations on 31 patients were perfomed with 100 % technical succes. On the post procedure cholangiograms , it was decided additional stenting in two patients. Two patients lost to follow-up. Ten (34,5 %) patients died in the first 30 days after this procedure without any sign of biliary obstruction. There were no procedure related major complications. Stent occlusion occurred in two patients after 89 and 181 days. Luminal patency was restored with a repeated percutaneous intraluminal RFA in the first patient. Of these 31 patients, 20 were dead and 9 patients were alive in the follow-up period. All patients had a median survival of 76 (5 239) days and a median stent patency of 76 (5 189) days. Percutaneously applied endoluminal RFA is a feasible and safe option in palliative treatment of malignant biliary obstruction with low complication rate and high technical succes.