Percutaneous Intraductal Microwave Ablation of Malignant Biliary Strictures: Initial Experience
- 1 September 2020
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 215 (3), 753-759
- https://doi.org/10.2214/AJR.19.21897
Abstract
OBJECTIVE. Metallic stenting of malignant biliary strictures is the preferred method of palliation, because most patients present when the condition is inoperable. Most metallic stents, however, are occluded 6-8 months after deployment. Intraductal radiofrequency ablation has been used in previous studies to improve stent patency. The purpose of this study was to assess a single-center experience with percutaneous intraductal microwave ablation of malignant biliary strictures. MATERIALS AND METHODS. In this retrospective case series study, data on 12 patients with malignant biliary obstruction who underwent percutaneous intraductal microwave ablation followed by metallic stenting were evaluated. Ablation procedures were performed with generator frequencies of 902-928 MHz, power set at 6-10 W, and ablation time of 60-90 seconds in a temperature-controlled manner with target temperature set at 80 degrees C. RESULTS. Causes of malignant biliary obstruction were pancreatic carcinoma in four patients, gastric antrum carcinoma in three, cholangiocarcinoma in two, metastasis in two, and gallbladder carcinoma in one patient. Percutaneous intraductal microwave ablation and metallic stenting were performed successfully in all patients. There was no procedural mortality or major complication. The most common minor complication was abdominal pain. Biliary decompression was achieved in all patients at the end of the first month. The mean follow-up time was 9.4 months. The median primary stent patency period was 231 days. There were two stent occlusions due to sludge formation, and two patients died during follow-up. CONCLUSION. Percutaneous intraductal microwave ablation of malignant biliary strictures is safe and feasible. Prospective randomized controlled studies with long-term results are warranted to determine the effectiveness of this technique in lengthening the stent patency period.Keywords
This publication has 43 references indexed in Scilit:
- Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early ResultsCardioVascular and Interventional Radiology, 2012
- EASL–EORTC Clinical Practice Guidelines: Management of hepatocellular carcinomaEuropean Journal Of Cancer, 2012
- Endoscopic management of occluded biliary uncovered metal stents: A multicenter experienceWorld Journal of Gastroenterology, 2011
- A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal malignant biliary obstructionGastrointestinal Endoscopy, 2010
- Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter studyGastrointestinal Endoscopy, 2010
- Radiofrequency and Microwave Ablation of the Liver, Lung, Kidney, and Bone: What Are the Differences?Current Problems in Diagnostic Radiology, 2009
- Primary patency of percutaneously inserted self-expanding metallic stents in patients with malignant biliary obstructionHPB, 2009
- Microwave Ablation of Hepatocellular CarcinomaOncology, 2007
- Photodynamic therapy of malignant biliary strictures using meso-tetrahydroxyphenylchlorinEuropean Journal of Gastroenterology & Hepatology, 2007