| 摘要: |
| 目的 探讨胆道支架引流联合腔内射频消融治疗胆道恶性梗阻的安全性及临床疗效。方法 前瞻性纳入18例因胆道恶性梗阻接受内镜逆行胆胰管造影(ERCP)治疗的患者,在胆管插管成功后,循导丝插入双极射频电极,于肿瘤部位进行射频消融,并留置胆道支架进行引流,观察治疗的安全性及临床疗效。结果 所有患者均成功接受射频消融治疗；胆道引流成功率为100%(18/18),12例患者留置塑料支架,6例患者留置金属支架,其中3例患者同期留置胰管支架；术后患者出现胆管炎2例,胰腺炎2例,均经短期对症治疗后控制；黄疸明显缓解率为61%(11/18)；中位随访期10.9(2.0~15.4)个月,3个月内支架通畅率为87%(13/15),6个月内支架通畅率为64%(9/14),12个月内支架通畅率为25%(2/8)；6个月生存率为67%(8/12),12个月生存率为50%(4/8)。结论 对于胆道恶性梗阻,胆道支架引流联合腔内射频消融治疗是安全可行的。 |
| 关键词: 胆道恶性梗阻 內镜逆行胆胰管造影术 支架 射频消融术 |
| DOI：10.3724/SP.J.1008.2013.00257 |
| 投稿时间：2013-01-18修订日期：2013-02-28 |
| 基金项目: |
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| Biliary drainage combined with intraductal radiofrequency ablation for treatment of malignant biliary obstruction |
| WU Jun,PAN Ya-min,WANG Tian-tian,GAO Dao-jian,HU Bing* |
(Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding author.) |
| Abstract: |
| Objective To evaluate the safety and clinical effectiveness of biliary drainage combined with endoscopic intraductal radiofrequency ablation (RFA) for treatment of malignant biliary obstruction. Methods Eighteen patients with malignant biliary obstruction, who were unsuitable for surgical resection, were prospectively selected for this study. During endoscopic retrograde cholangiopancreatography (ERCP), when biliary cannulation was successfully done, a bipolar radiofrequency probe was introduced into the bile duct via a guide wire. RFA was done under fluoroscopy, which was followed by stent placement. The patients were closely observed and followed up after procedure. Results All patients received successful RFA and biliary drainage. Twelve patients were implanted with plastic stents and 6 with metal stents; 3 patients were also implanted with pancreatic stents. Four patients developed mild complications (2 cholangitis and 2 pancreatitis), which were controlled by conservative therapy. Jaundice was promptly controlled in 61% (11/18) patients. The patients were followed up for a median of 10.9 months (range 2.0-15.4 months). The stent patency rates of 3 months, 6 months and 12 months were 87%(13/15), 64% (9/14) and 25% (2/8), respectively. The 6 month- and 12 month-survival rates were 67% (8/12) and 50% (4/8), respectively. Conclusion Biliary drainage combined with endoscopic intraductal RFA is technically feasible and safe for treatment of malignant biliary obstruction. |
| Key words: malignant biliary obstruction endoscopic retrograde cholangiopancreatography stents radiofrequency ablation |
