射频消融导管联合支架治疗恶性梗阻性黄疸 postprint

Abstract: Objective To investigate the safety and feasibility of percutaneous intraductal radiafrequency ablation(RFA) plus biliary stenting in the treatment of malignant biliary obstruction. Methods A total of 13 patients with unresectable malignant obstructive jaundice were selected to undergo percutaneus intraductal radiofrequency ablation plus metallic biliary stmt placement. Clinical efficacy was evaluated by observing the operative complications, remission of jaundice, and the stmt patency and survival rate at 1, 3, 6 months were also recorded. Results Patients were successfully received the intraductal RFA. No complications such as perforation, biliary leakage or bile peritonitis occurred. Serum total bilirubin was significantly decreased in 1 week(t=5.156, P<0.01) , and the jaundice remission rate was 61.5%. The 1, 3 month patency rate was 100%, the 6 month patency rate was 80%(8/10). The 1 month survival rate was 100%, The 3, 6 month survival rate was 92%(12/13)and 77% (10/13)respectively Two patients dead of serious drain with advanced tumors in 65,132 days after operation respectively and one patient dead of disseminated intravascular coagulation in 97 days. Jaundice recurrence occurred in two patients in 4-5 months after the procedure were controlled after received the interventional treatment again. Conclusion Percutaneous intraductal radiafrequency ablation(RFA) could prolong the malignant biliary obstruction patients' stmt patency and life time effectively and safely while its long-term efficacy needs to be further proved.