Efficacy of percutaneous intraductal radiofrequency ablation combined with biliary stenting in treatment of malignant biliary obstruction

Objective To investigate the safety and feasibility of percutaneous intraductal radiofrequency ablation(palliative therapy) in the treatment of malignant obstructive jaundice.Methods This study included 20 patients with unresectable malignant obstructive jaundice,who were treated in the First Affiliated Hospital of Zhengzhou University from January 2013 to March 2014.Nine of them(test group) underwent percutaneous intraductal radiofrequency ablation plus metallic biliary stent placement.The other 11 similar cases(control group) underwent metallic biliary stent placement alone after successful percutaneous transhepatic cholangiography.Operative complications and remission of jaundice were observed,and the stent patency after at 3 and 6 months after operation was evaluated and compared between the two groups.Results All patients were followed completely by outpatient or telephone.The stent patency rate at 3 months after operation was 9 /9 in the test group and 8 /11 in the control group(χ2= 2.888,P = 0.218),and the stent patency rates at 6 months were 7 /8 and 3 /11,respectively(χ2= 6.739,P = 0.02).During follow-up,one case in the test group died of gastrointestinal bleeding at 113 d after operation;one case in the control group died of liver failure at 57 d after operation and one case died of disseminated intravascular coagulation at 142 d.Conclusion Percutaneous intraductal radiofrequency ablation is safe and feasible in the treatment of malignant biliary obstruction,and the preliminary efficacy in prolonging the patency of self-expanding metallic stent is satisfactory.However,this therapy needs to be further verified via large-sample randomized controlled studies.