Hoonsub So1, Chi Hyuk Oh2, Tae Jun Song3, Hyun Woo Lee4, Jun Seong Hwang5, Sung Woo Ko6, Dongwook Oh3, Do Hyun Park3, Sang Soo Lee3, Dong-Wan Seo3, Sung Koo Lee3, Myung-Hwan Kim3. 1. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea. 2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul 02453, Korea. 3. Asan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea. 4. Division of Gastroenterology, Department of Internal Medicine, Gimpo Woori Hospital, Gimpo 10099, Korea. 5. Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan 48108, Korea. 6. Department of Internal Medicine, Eunpyeong St. Mary's Hospital, Catholic University, Seoul 03312, Korea.
Abstract
Background. Radiofrequency ablation (RFA) is a palliative method known for its application in the endoscopic treatment of malignant bile duct obstruction. It may be a useful rescue method for metal stent malfunction caused by tumor ingrowth. This study aimed to examine the feasibility and safety of endoluminal RFA for occluded bilateral hilar metal stents due to tumor ingrowth in patients with malignant hilar bile duct obstruction. Methods: From March 2016 to June 2018, 11 patients with unresectable malignant hilar bile duct stricture with occluded bilateral hilar metal stents due to tumor ingrowth were enrolled. Endoluminal RFA was performed through a novel temperature-controlled catheter at a setting of 7 W power for 120 s with a target temperature of 80 °C via endoscopic retrograde cholangiopancreatography (ERCP). The patients' demographics, clinical outcomes, and adverse events were investigated. Results: The median age was 64 (interquartile range, 54-72) years. All RFA procedures were successful. Clinical success was achieved in eight patients (72.7%). During the follow-up, eight patients (72.7%) showed stent dysfunction, and the median patency after RFA was 50 days (95% confidence interval (CI): 34-not available (NA)). All stent dysfunctions were successfully managed with ERCP. Ten patients died, and the median overall survival was 289 days (95% CI, 107-NA) from RFA to death. There was one case of mild abdominal pain after the procedure without serious adverse events. Conclusions: As a rescue therapy for occluded bilateral hilar metal stents due to tumor ingrowth, endoluminal RFA seemed to be safe and useful in selected patients.
Background. Radiofrequency ablation (RFA) is a palliative method known for its application in the endoscopic treatment of malignant bile duct obstruction. It may be a useful rescue method for metal stent malfunction caused by tumor ingrowth. This study aimed to examine the feasibility and safety of endoluminal RFA for occluded bilateral hilar metal stents due to tumor ingrowth in patients with malignant hilar bile duct obstruction. Methods: From March 2016 to June 2018, 11 patients with unresectable malignant hilar bile duct stricture with occluded bilateral hilar metal stents due to tumor ingrowth were enrolled. Endoluminal RFA was performed through a novel temperature-controlled catheter at a setting of 7 W power for 120 s with a target temperature of 80 °C via endoscopic retrograde cholangiopancreatography (ERCP). The patients' demographics, clinical outcomes, and adverse events were investigated. Results: The median age was 64 (interquartile range, 54-72) years. All RFA procedures were successful. Clinical success was achieved in eight patients (72.7%). During the follow-up, eight patients (72.7%) showed stent dysfunction, and the median patency after RFA was 50 days (95% confidence interval (CI): 34-not available (NA)). All stent dysfunctions were successfully managed with ERCP. Ten patientsdied, and the median overall survival was 289 days (95% CI, 107-NA) from RFA to death. There was one case of mild abdominal pain after the procedure without serious adverse events. Conclusions: As a rescue therapy for occluded bilateral hilar metal stents due to tumor ingrowth, endoluminal RFA seemed to be safe and useful in selected patients.
Authors: Abdurrahman Kadayifci; Mustafa Atar; David G Forcione; Brenna W Casey; Peter B Kelsey; William R Brugge Journal: Endoscopy Date: 2016-10-07 Impact factor: 10.093
Authors: Werner Dolak; Florian Schreiber; Hubert Schwaighofer; Michael Gschwantler; Wolfgang Plieschnegger; Alexander Ziachehabi; Andreas Mayer; Ludwig Kramer; Andreas Kopecky; Christiane Schrutka-Kölbl; Gernot Wolkersdörfer; Christian Madl; Frieder Berr; Michael Trauner; Andreas Püspök Journal: Surg Endosc Date: 2013-10-03 Impact factor: 4.584
Authors: Ban Seok Lee; Ji Kon Ryu; Dong Kee Jang; Kwang Hyun Chung; Won Jae Yoon; Jaihwan Kim; Sang Myung Woo; Sang Hyub Lee; Woo Jin Lee; Yong-Tae Kim Journal: J Gastroenterol Hepatol Date: 2016-11 Impact factor: 4.029