Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction

Li, Teng-Fei; Huang, Guo‐Hao; Li, Zhen; Hao, Changfu; Ren, Jianzhuang; Duan, Xuhua; Zhang, Kai; Chen, Chen; Han, Xinwei; Jiao, Dechao; Zhang, Mengfan; Wang, Yanli

doi:10.1016/j.jvir.2015.01.037

Cited by 32 publications

(45 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the easy and minimally invasive procedure, intraductal RFA was used to clear occluded metal stents [21], which was also confirmed by our previous study [15]. 1 previous report asserted that ablation treatment should be performed cautiously because of excessive charring leading to perforation [10]. The intraductal RFA can destroy the tumor tissue to some extent to enlarge the lumen for stent placement, leading to blood vessel loss; this was reported by Monga et al [22].…”

Section: Discussionsupporting

confidence: 61%

“…With a high retrograde infection rate, we recommend that antibiotics should be regularly used prophylactically in these patients. We speculate that cholangitis may be associated with the wire guide that was advanced into the duodenum, carrying intestinal bacteria that resulted in retrograde infection [10,15].…”

Section: Discussionmentioning

confidence: 99%

“…Stent patency was demonstrated if jaundice was not observed, the direct bilirubin level was normal, and bile duct expansion was not displayed on ultrasound (US)/computed tomography (CT)/magnetic resonance (MR) imaging during the follow-up [10].…”

Section: Assessment and Follow-upmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction Caused by Recurrence and Metastasis after Primary Tumor Resection

Cui

Fan²,

Lu³

et al. 2018

Oncol Res Treat

View full text Add to dashboard Cite

Background: To assess the feasibility and safety of percutaneous intraductal radiofrequency ablation (RFA) for malignant biliary obstruction caused by recurrence and metastasis after primary tumor resection. Patients and Methods: Percutaneous intraductal biliary RFA and stent placement were performed in 19 consecutive patients with 24 RFA procedures. Procedure-related complications, stent patency, and survival after treatment were investigated. Results: During 30 days after each RFA procedure there was no 30-day mortality, hemorrhage, bile duct perforation, or pancreatitis. Of the 19 patients, 2 are still alive and 17 are dead with a median survival time of 6.0 (range 1.2-16) months and a median stent patency of 3.2 (range 1.2-14) months. 10 patients had their stent patent at the time of last follow-up or death. 3 patients with stent blockage at 50, 182, and 200 days post procedure underwent repeat ablation. 1 patient with stent blockage underwent 2 repeat RFA procedures at 192 days after the first ablation and at 86 days after the repeat ablation. Conclusion: Percutaneous intraductal RFA is a technically safe and feasible therapeutic option for palliative treatment of these selected patients.

show abstract

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction Caused by Recurrence and Metastasis after Primary Tumor Resection

Cui

Fan²,

Lu³

et al. 2018

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…If there was no evidence of obstruction while the patient was alive, the patency period was considered to be equal to the survival period, but was censored. Stent patency was confirmed by the absence of jaundice, normal levels of direct bilirubin, and the absence of bile duct expansion on US, CT or MR imaging during follow-up [19]. Overall survival (OS) was calculated from the date of the first procedure until the date of death.…”

Section: Methodsmentioning

confidence: 99%

“…An open-label pilot study involving 22 patients with malignant biliary strictures confirmed the safety and feasibility of this radiofrequency ablation (RFA) technique for clinical use [12]. The technique has shown promising results in the palliative treatment of malignant biliary strictures, preventing stent occlusion [13–18], clearing blocked metal stents [7], prolonging stent patency [19], and improving patient survival [20]. We previously reported our early experience in managing patients with unresectable Bismuth types III and IV hilar cholangiocarcinoma using biliary RFA, and demonstrated that the long-term efficacy and safety is promising [21].…”

Section: Introductionmentioning

confidence: 99%

The safety and efficacy of percutaneous intraductal radiofrequency ablation in unresectable malignant biliary obstruction: A single-institution experience

Cui

Fan

et al. 2017

BMC Cancer

View full text Add to dashboard Cite

BackgroundPatients with unresectable malignant biliary obstruction have limited life expectancy because of limited stent patency and tumor progression. The aim of our study was to retrospectively evaluate the safety and efficacy of combining intraductal RFA with biliary metal stent placement for patients with malignant biliary obstruction.MethodsPatients who received percutaneous intraductal RFA and biliary stent placement for malignant biliary obstruction between 2013 and 2015 were identified. Outcomes were stent patency, technique and clinical success rate, overall survival (OS) and complication rates. Kaplan-Meier and Cox regression analyses were used to examine the association of various factors with stent patency and OS. Complications and laboratory abnormalities were recorded.ResultsFifty patients were treated with percutaneous RFA and stent placement. The rates of technical success and clinical success were 98% and 92%, respectively. The median stent patency was 7.0 (95% confidence interval [CI]: 5.3, 8.7) months and OS was 5.0 (95% CI: 4.0, 6.0) months. On univariable analysis, previously cholangitis was an independent poor prognosis factor for recurrent biliary obstruction. OS was improved in patients who received more than one intervention compared to those who received only one intervention (log-rank P = 0.007), and in those treated without versus those treated with sequential chemotherapy (log-rank P = 0.017). On multivariable analysis, the occurrence of more than one intervention (P = 0.019) had independent prognostic significance for OS.ConclusionPercutaneous RFA and stent placement is a technically safe and feasible therapeutic option for the palliative treatment of malignant biliary obstruction. The long-term efficacy and safety of the procedure is promising, but further study is required via randomized and prospective trials.

show abstract

Combined immune checkpoint inhibition with durvalumab and tremelimumab with and without radiofrequency ablation in patients with advanced biliary tract carcinoma

Monge,

Xie,

Myojin

et al. 2024

Cancer Medicine

View full text Add to dashboard Cite

BackgroundCurrent standard of care for advanced biliary tract cancer (BTC) is gemcitabine, cisplatin plus anti‐PD1/PD‐L1, but response rates are modest. The purpose of this study was to explore the efficacy and safety of durvalumab (anti‐PD‐L1) and tremelimumab (anti‐CTLA‐4), with and without an interventional radiology (IR) procedure in advanced BTC.MethodsEligible patients with advanced BTC who had received or refused at least one prior line of systemic therapy were treated with tremelimumab and durvalumab for four combined doses followed by monthly durvalumab alone with and without an IR procedure until the progression of disease or unacceptable toxicity. Objective response was assessed through CT or MRI by Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1) every 8 weeks. Adverse events (AEs) were recorded and managed. The primary endpoint was 6‐month progression‐free survival (PFS).ResultsTwenty‐three patients with advanced BTC were enrolled; 17 patients were assigned to treatment with durvalumab and tremelimumab (Durva/Treme); and 6 patients were treated with the combination of durvalumab, tremelimumab plus IR procedure (Durva/Treme + IR). The best clinical responses in the Durva/Treme arm were partial response (n = 1), stable disease (n = 5), progressive disease (n = 5), and in the Durva/Treme + IR arm: partial response (n = 0), stable disease (n = 3), progressive disease (n = 3). The median PFS was 2.2 months (95% CI: 1.3–3.1 months) in the Durva/Treme arm and 2.9 months (95% CI: 1.9–4.7 months) in the Durva/Treme + IR arm (p = 0.27). The median OS was 5.1 months (95% CI: 2.5–6.9 months) in the Durva/Treme arm and 5.8 months (95% CI: 2.9–40.1 months) in the Durva/Treme + IR arm (p = 0.31). The majority of AEs were grades 1–2.ConclusionDurva/Treme and Durva/Treme + IR showed similar efficacy. With a manageable safety profile. Larger studies are needed to fully characterize the efficacy of Durva/Treme ± IR in advanced BTC.

show abstract

Percutaneous Transhepatic Cholangiography and Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Malignant Biliary Obstruction

Cited by 32 publications

References 23 publications

Percutaneous Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction Caused by Recurrence and Metastasis after Primary Tumor Resection

Percutaneous Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction Caused by Recurrence and Metastasis after Primary Tumor Resection

The safety and efficacy of percutaneous intraductal radiofrequency ablation in unresectable malignant biliary obstruction: A single-institution experience

Combined immune checkpoint inhibition with durvalumab and tremelimumab with and without radiofrequency ablation in patients with advanced biliary tract carcinoma

Contact Info

Product

Resources

About