Percutaneous endobiliary ablation (RFA and MWA) prior to stenting: assessing feasibility and outcomes in malignant biliary obstruction

Öz

Purpose: This study aims to evaluate the feasibility and effectiveness of percutaneous endobiliary Microwave Ablation (MWA) and Radiofrequency Ablation (RFA) prior to metallic stent placement for managing symptomatic, unresectable malignant biliary obstructions (MBOs).
Materials and methods: We conducted a retrospective cohort analysis of 122 patients diagnosed with malignant tumors causing biliary obstructions, comparing outcomes between those receiving stents only and those undergoing prior ablation. Data collected included patient demographics, procedural details, complication rates, stent patency, and overall survival.
Results: Among the 122 patients, 101 received stents alone, while 21 underwent ablation (13 with MWA and 8 with RFA). There was no significant difference in stent patency duration (255.7 days for ablation vs. 219.6 days for stent-only, p=0.218) or overall survival (average of 123 days, p=0.105). The complication rate was significantly higher in the ablation group (p=0.023).
Conclusion: While endobiliary ablative treatments before metallic stenting appear feasible for palliative care of unresectable MBOs, our findings indicate no significant improvement in stent patency or overall survival. Further randomized controlled studies are necessary to clarify the efficacy and necessity of these techniques.

Anahtar Kelimeler

• Malignant biliary obstruction
• endobiliary ablative treatments
• microwave ablation (MWA)
• radiofrequency ablation (RFA)
• stent patency

Stentleme öncesi perkütan endobiliyer ablasyon (RFA ve MWA): malign biliyer obstrüksiyonda uygulanabilirliğin ve klinik sonuçların değerlendirilmesi

Öz

Amaç: Bu çalışma, semptomatik ve rezektabl olmayan malign biliyer obstrüksiyonlarının (MBO) palyatif tedavisinde metalik stent yerleştirilmeden önce perkütan endobiliyer Mikrodalga Ablasyon (MDA) ve Radyofrekans Ablasyonun (RFA) uygulanabilirliğini ve etkinliğini değerlendirmeyi amaçlamaktadır.
Gereç ve yöntem: Malign tümörlere bağlı safra yolu obstrüksiyonu tanısı alan 122 hastanın retrospektif kohort analizi yapıldı. Yalnızca stent yerleştirilen hastalar ile stent öncesi ablasyon uygulanan hastaların sonuçları karşılaştırıldı. Çalışmada hasta demografileri, girişimsel ayrıntılar, komplikasyon oranları, stent açıklığı ve genel sağkalım verileri incelendi.
Bulgular: Toplam 122 hastanın 101’ine yalnızca stent yerleştirilirken, 21 hastaya ablasyon uygulandı (13 MDA, 8 RFA). Stent açıklığı süresinde (ablasyon grubu 255,7 gün; yalnız stent grubu 219,6 gün; p=0,218) veya genel sağkalımda (ortalama 123 gün; p=0,105) anlamlı fark saptanmadı. Ablasyon grubunda komplikasyon oranı anlamlı derecede yüksekti (p=0,023).
Sonuç: Rezektabl olmayan MBO’ların palyatif tedavisinde metalik stentleme öncesi endobiliyer ablasyon yöntemleri uygulanabilir görünmekle birlikte, çalışmamız stent açıklığı veya genel sağkalım açısından anlamlı bir iyileşme göstermemektedir. Bu tekniklerin etkinliği ve gerekliliğini netleştirmek için ileriye dönük randomize kontrollü çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Malign biliyer obstrüksiyon
• endobiliyer ablatif tedaviler
• mikrodalga ablasyon (MDA)
• radyofrekans ablasyon (RFA)
• stent açıklığı

Kaynakça

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