Clinical Trials Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2017; 23(10): 1851-1856
Published online Mar 14, 2017. doi: 10.3748/wjg.v23.i10.1851
Percutaneous intraductal radiofrequency ablation for treatment of biliary stent occlusion: A preliminary result
Ning Xia, Ju Gong, Jian Lu, Zhi-Jin Chen, Li-Yun Zhang, Zhong-Min Wang
Ning Xia, Ju Gong, Jian Lu, Zhi-Jin Chen, Li-Yun Zhang, Zhong-Min Wang, Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
Zhong-Min Wang, Department of Intervention, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Author contributions: Xia N, Gong J and Lu J contributed equally to this work; Xia N, Gong J and Wang ZM designed the research; Xia N, Gong J and Wang ZM performed the research; Xia N, Lu J, Chen ZJ and Zhang LY analyzed the data; and Xia N wrote the paper.
Supported by the Youth Foundation of the Shanghai Public Health Bureau, No. 20134Y195; and the Project of Medical Key Specialty of Shanghai Municipality, No. ZK2015A22.
Institutional review board statement: The study was reviewed and approved by the Ruijin Hospital Luwan Branch Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None declared.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zhong-Min Wang, MD, Professor, Department of Intervention, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. james0722@163.com
Telephone: +86-21-63864050 Fax: +86-21-63860461
Received: September 26, 2016
Peer-review started: September 28, 2016
First decision: October 20, 2016
Revised: November 10, 2016
Accepted: January 17, 2017
Article in press: January 17, 2017
Published online: March 14, 2017
Abstract
AIM

To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction.

METHODS

We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter.

RESULTS

Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to follow-up. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 ± 65 μmol/L and 63 ± 29 μmol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients’ stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d.

CONCLUSION

This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.

Keywords: Percutaneous transhepatic cholangiography, Intraductal radiofrequency, Malignant obstructive jaundice

Core tip: This study sought to assess the feasibility and effectiveness of a novel application of percutaneous radiofrequency ablation in the treatment of biliary stent obstruction. We report a retrospective study with the results of percutaneous intraductal radiofrequency ablation in patients with biliary stent occlusion.