한빛사논문
- 조회390
Namyoung Park MD 1,2, Min Kyu Jung MD, PhD 3, Eui Joo Kim MD 4, Woo Hyun Paik MD, PhD 1∗, Jae Hee Cho MD, PhD 5∗
1Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
2Department of Gastroenterology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, 50 Samduk-Dong 2 Ga, Chung-Gu, Daegu, Korea
4Division of Gastroenterology, Department of Internal Medicine, Gil Medical Center, College of Medicine Gachon University, Incheon, Korea
5Department of Internal Medicine, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea
Corresponding authors: Woo Hyun Paik, MD, PhD., Jae Hee Cho MD, PhD
Abstract
Background and aims: In patients with unresectable malignant biliary obstruction (MBO), endoscopic drainage with a self-expandable metal stent (SEMS) is a well-established treatment, but stent patency is limited. This study aimed to evaluate the efficacy of in-stent radiofrequency ablation (IS-RFA) followed by uncovered SEMS placement for the management of occluded SEMSs.
Methods: From 2016 to 2020, 48 patients with recurrent biliary obstruction due to tumor ingrowth or overgrowth after SEMS placement for pancreatobiliary cancer in three tertiary hospitals were analyzed. For distal MBO, patients in RFA group were treated with IS-RFA and uncovered SEMS placement, and those in control group were treated with uncovered SEMS placement alone. Patients in both groups were matched based on propensity scores in a 1:1 ratio.
Results: The median time to recurrent biliary obstruction (TRBO) was 117 days in the RFA group and 82.5 days in the control group (p = 0.029). No significant differences in median overall survival were detected between the two groups (170 days vs. 72 days, p = 0.902). No significant adverse events were reported after the second SEMS placement in either group, but two cases of mild cholangitis were reported in the control group. Ablation was interrupted in five patients (35.7%) from the RFA group due to in-stent contact, but sufficient ablative energy was delivered in majority of the patients after repeating the IS-RFA (92.9%) in the same session.
Conclusions: IS-RFA followed by uncovered SEMS is safe and feasible and may improve TRBO as a stent revision for occluded SEMS in pancreatobiliary cancer.
논문정보
- Research article
- 2022년 11월 (BRIC 등록일 2023-02-15)
- 국내 연구진
- 의약학 > 응용의학
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