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Efficacy and safety of temperature-controlled intraductal radiofrequency ablation in advanced malignant hilar biliary obstruction: A pilot multicenter randomized comparative trial

Authors
 Huapyong Kang  ;  Sung Yong Han  ;  Jae Hee Cho  ;  Eui Joo Kim  ;  Dong Uk Kim  ;  Jae Kook Yang  ;  Soyoung Jeon  ;  Goeun Park  ;  Tae Hoon Lee 
Citation
 JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, Vol.29(4) : 469-478, 2022-04 
Journal Title
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
ISSN
 1868-6974 
Issue Date
2022-04
MeSH
Bile Duct Neoplasms* / complications ; Bile Duct Neoplasms* / surgery ; Catheter Ablation* / adverse effects ; Cholestasis* / diagnostic imaging ; Cholestasis* / etiology ; Cholestasis* / surgery ; Humans ; Radiofrequency Ablation* / adverse effects ; Stents / adverse effects ; Temperature ; Treatment Outcome
Keywords
cholangiocarcinoma ; cholangiopancreatography ; cholestasis ; endoscopic retrograde ; gallbladder neoplasms ; radiofrequency ablation
Abstract
Purpose: We aimed to evaluate the efficacy and safety of temperature-controlled intraductal radiofrequency ablation (ID-RFA) for advanced malignant hilar biliary obstruction (MHBO).

Methods: Patients were randomly assigned to RFA group (ID-RFA and bilateral plastic stent [PS]) or non-RFA group (bilateral PS) at a 1:1 ratio. Exchange to self-expanding metal stent (SEMS) was performed after 3 months or when premature PS occlusion occurred. Total event-free stent patency, overall survival (OS), and adverse events (AEs) were analyzed.

Results: A total of 30 patients from three hospitals were enrolled. Stent patency and OS did not differ between the two groups (178 days vs 122 days, P = .154; 230 days vs 144 days, P = .643; respectively). In patients with each stricture length ≥11 mm on both sides, stent patency was longer in the RFA group than in the non-RFA group (175 days vs 121 days, P = .028). More patients received elective exchange to SEMS without PS occlusion in the RFA group than in the non-RFA group (69.2% vs 23.1%, P = .018). AE rates did not differ between the two groups.

Conclusions: Temperature-controlled ID-RFA for advanced MHBO was safe and feasible. It could prevent premature PS occlusion within 3 months.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.1082
DOI
10.1002/jhbp.1082
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kang, Huapyong(강화평) ORCID logo https://orcid.org/0000-0003-1790-0809
Park, Goeun(박고은)
Cho, Jae Hee(조재희) ORCID logo https://orcid.org/0000-0003-4174-0091
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188667
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