Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study
<b>Background.</b> 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 feasibi...
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/5/952 |
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| author | Hoonsub So Chi Hyuk Oh Tae Jun Song Hyun Woo Lee Jun Seong Hwang Sung Woo Ko Dongwook Oh Do Hyun Park Sang Soo Lee Dong-Wan Seo Sung Koo Lee Myung-Hwan Kim |
| author_facet | Hoonsub So Chi Hyuk Oh Tae Jun Song Hyun Woo Lee Jun Seong Hwang Sung Woo Ko Dongwook Oh Do Hyun Park Sang Soo Lee Dong-Wan Seo Sung Koo Lee Myung-Hwan Kim |
| author_sort | Hoonsub So |
| collection | DOAJ |
| description | <b>Background.</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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. |
| first_indexed | 2024-03-09T06:06:09Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T06:06:09Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-432bead6f7b340e29f29d6085d17707c2023-12-03T12:03:45ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-0110595210.3390/jcm10050952Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot StudyHoonsub So0Chi Hyuk Oh1Tae Jun Song2Hyun Woo Lee3Jun Seong Hwang4Sung Woo Ko5Dongwook Oh6Do Hyun Park7Sang Soo Lee8Dong-Wan Seo9Sung Koo Lee10Myung-Hwan Kim11Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul 02453, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, KoreaDivision of Gastroenterology, Department of Internal Medicine, Gimpo Woori Hospital, Gimpo 10099, KoreaDepartment of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan 48108, KoreaDepartment of Internal Medicine, Eunpyeong St. Mary’s Hospital, Catholic University, Seoul 03312, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, KoreaAsan Medical Center, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea<b>Background.</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.https://www.mdpi.com/2077-0383/10/5/952cholangiocarcinomaendoscopic retrograde cholangiopancreatographyradiofrequency ablation |
| spellingShingle | Hoonsub So Chi Hyuk Oh Tae Jun Song Hyun Woo Lee Jun Seong Hwang Sung Woo Ko Dongwook Oh Do Hyun Park Sang Soo Lee Dong-Wan Seo Sung Koo Lee Myung-Hwan Kim Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study Journal of Clinical Medicine cholangiocarcinoma endoscopic retrograde cholangiopancreatography radiofrequency ablation |
| title | Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study |
| title_full | Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study |
| title_fullStr | Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study |
| title_full_unstemmed | Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study |
| title_short | Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study |
| title_sort | feasibility and safety of endoluminal radiofrequency ablation as a rescue treatment for bilateral metal stent obstruction due to tumor ingrowth in the hilum a pilot study |
| topic | cholangiocarcinoma endoscopic retrograde cholangiopancreatography radiofrequency ablation |
| url | https://www.mdpi.com/2077-0383/10/5/952 |
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