Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications
Background Biliary radiofrequency ablation (RFA) using the Habib™ EndoHBP catheter is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to assess the feasibility and safety of this technique. Methods In this nationwide retrospective study of prospective...
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| Veröffentlicht in: | Surgical endoscopy 2014-03, Vol.28 (3), p.854-860 |
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| creator | Dolak, Werner Schreiber, Florian Schwaighofer, Hubert Gschwantler, Michael Plieschnegger, Wolfgang Ziachehabi, Alexander Mayer, Andreas Kramer, Ludwig Kopecky, Andreas Schrutka-Kölbl, Christiane Wolkersdörfer, Gernot Madl, Christian Berr, Frieder Trauner, Michael Püspök, Andreas |
| description | Background
Biliary radiofrequency ablation (RFA) using the Habib™ EndoHBP catheter is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to assess the feasibility and safety of this technique.
Methods
In this nationwide retrospective study of prospectively collected clinical data, all patients treated by biliary RFA in Austria between November 2010 and December 2012 were included. Procedure-related complications, adverse events within 30 days post-intervention, stent patency, and mortality rates were investigated.
Results
A total of 58 patients (31 male, 27 female, median age 75 years) underwent 84 RFA procedures at 11 Austrian referral centers for biliary endoscopy. The predominant underlying condition was Klatskin tumor (45 of 58 cases). All 84 RFA procedures were feasible without technical problems. A partial liver infarction was induced by RFA in a 49-year-old Klatskin tumor patient. During 30 days after each RFA procedure, five cases of cholangitis, three cases of hemobilia, two cases of cholangiosepsis, and one case each of gallbladder empyema, hepatic coma, and newly diagnosed left bundle branch block occurred. Median stent patency after last electively performed RFA was 170 days (95 % CI 63–277) and was almost significantly different between metal and plastic stenting (218 vs. 115 days;
p
= 0.051). Median survival was 10.6 months (95 % CI 6.9–14.4) from the time of the first RFA in each patient and 17.9 months (95 % CI 10.3–25.6) from the time of initial diagnosis.
Conclusions
Except for one severe interventional complication (hepatic infarct), RFA presented as a technically feasible and safe therapeutic option for the palliative treatment of malignant biliary obstruction. The good results of stent patency and survival in this study should be proven in prospective (controlled) trials to further quantify the efficacy of this promising new technique. |
| doi_str_mv | 10.1007/s00464-013-3232-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1501837031</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3225827931</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-60f516f44de1cd4abbfbd3e375bc449b24e2dc6a93ec5a7b66cdd1301efcfca3</originalsourceid><addsrcrecordid>eNp1kc9qFTEUxoNY7G3rA7iRgBs3Y_NvZm7cSalVKHTTfUhOTkrK3GRMZpQ-gO9t7r1VRHCVkPP7vnNOPkLecPaBMzZeVsbUoDrGZSeFFJ1-QTZctYsQfPuSbJiWrBOjVqfkrNZH1nDN-1fkVCiuh16NG_LzOvlcIc8RaLE-5lDw24oJnqh1k11iTjTkQnd2ig_JpoW6OEVbnmh2dSkr7ImP1NJ0YH9Ej7TgUnKdsdW-I63L6hsd6FZRyKkirId3O89ThIOqXpCTYKeKr5_Pc3L_-fr-6kt3e3fz9erTbQdyFEs3sNDzISjlkYNX1rngvEQ59g6U0k4oFB4GqyVCb0c3DOA9l4xjgABWnpP3R9u55LZkXcwuVsBpsgnzWg3vGd_KkUne0Hf_oI95LakNt6eY5myUfaP4kYK2cC0YzFzirv2O4czsIzLHiEyLyOwjMrpp3j47r26H_o_idyYNEEegtlJ6wPJX6_-6_gIFSKAr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1500910735</pqid></control><display><type>article</type><title>Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Dolak, Werner ; Schreiber, Florian ; Schwaighofer, Hubert ; Gschwantler, Michael ; Plieschnegger, Wolfgang ; Ziachehabi, Alexander ; Mayer, Andreas ; Kramer, Ludwig ; Kopecky, Andreas ; Schrutka-Kölbl, Christiane ; Wolkersdörfer, Gernot ; Madl, Christian ; Berr, Frieder ; Trauner, Michael ; Püspök, Andreas</creator><creatorcontrib>Dolak, Werner ; Schreiber, Florian ; Schwaighofer, Hubert ; Gschwantler, Michael ; Plieschnegger, Wolfgang ; Ziachehabi, Alexander ; Mayer, Andreas ; Kramer, Ludwig ; Kopecky, Andreas ; Schrutka-Kölbl, Christiane ; Wolkersdörfer, Gernot ; Madl, Christian ; Berr, Frieder ; Trauner, Michael ; Püspök, Andreas ; Austrian Biliary RFA Study Group ; for the Austrian Biliary RFA Study Group</creatorcontrib><description>Background
Biliary radiofrequency ablation (RFA) using the Habib™ EndoHBP catheter is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to assess the feasibility and safety of this technique.
Methods
In this nationwide retrospective study of prospectively collected clinical data, all patients treated by biliary RFA in Austria between November 2010 and December 2012 were included. Procedure-related complications, adverse events within 30 days post-intervention, stent patency, and mortality rates were investigated.
Results
A total of 58 patients (31 male, 27 female, median age 75 years) underwent 84 RFA procedures at 11 Austrian referral centers for biliary endoscopy. The predominant underlying condition was Klatskin tumor (45 of 58 cases). All 84 RFA procedures were feasible without technical problems. A partial liver infarction was induced by RFA in a 49-year-old Klatskin tumor patient. During 30 days after each RFA procedure, five cases of cholangitis, three cases of hemobilia, two cases of cholangiosepsis, and one case each of gallbladder empyema, hepatic coma, and newly diagnosed left bundle branch block occurred. Median stent patency after last electively performed RFA was 170 days (95 % CI 63–277) and was almost significantly different between metal and plastic stenting (218 vs. 115 days;
p
= 0.051). Median survival was 10.6 months (95 % CI 6.9–14.4) from the time of the first RFA in each patient and 17.9 months (95 % CI 10.3–25.6) from the time of initial diagnosis.
Conclusions
Except for one severe interventional complication (hepatic infarct), RFA presented as a technically feasible and safe therapeutic option for the palliative treatment of malignant biliary obstruction. The good results of stent patency and survival in this study should be proven in prospective (controlled) trials to further quantify the efficacy of this promising new technique.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-013-3232-9</identifier><identifier>PMID: 24196547</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Abdominal Surgery ; Ablation ; Adult ; Aged ; Aged, 80 and over ; Animals ; Austria - epidemiology ; Bile Duct Neoplasms - complications ; Bile Duct Neoplasms - diagnosis ; Bile ducts ; Catheter Ablation - instrumentation ; Catheters ; Cats ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde - methods ; Cholangitis ; Cholestasis - diagnosis ; Cholestasis - etiology ; Cholestasis - surgery ; Endoscopy ; Equipment Design ; Female ; Follow-Up Studies ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Incidence ; Internal medicine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Palliative Care - methods ; Patients ; Postoperative Complications - epidemiology ; Proctology ; Quality of life ; Retrospective Studies ; Stents ; Surgery ; Surgery, Computer-Assisted - methods ; Survival Rate - trends ; Time Factors ; Tumors</subject><ispartof>Surgical endoscopy, 2014-03, Vol.28 (3), p.854-860</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>Springer Science+Business Media New York 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-60f516f44de1cd4abbfbd3e375bc449b24e2dc6a93ec5a7b66cdd1301efcfca3</citedby><cites>FETCH-LOGICAL-c372t-60f516f44de1cd4abbfbd3e375bc449b24e2dc6a93ec5a7b66cdd1301efcfca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-013-3232-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-013-3232-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24196547$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dolak, Werner</creatorcontrib><creatorcontrib>Schreiber, Florian</creatorcontrib><creatorcontrib>Schwaighofer, Hubert</creatorcontrib><creatorcontrib>Gschwantler, Michael</creatorcontrib><creatorcontrib>Plieschnegger, Wolfgang</creatorcontrib><creatorcontrib>Ziachehabi, Alexander</creatorcontrib><creatorcontrib>Mayer, Andreas</creatorcontrib><creatorcontrib>Kramer, Ludwig</creatorcontrib><creatorcontrib>Kopecky, Andreas</creatorcontrib><creatorcontrib>Schrutka-Kölbl, Christiane</creatorcontrib><creatorcontrib>Wolkersdörfer, Gernot</creatorcontrib><creatorcontrib>Madl, Christian</creatorcontrib><creatorcontrib>Berr, Frieder</creatorcontrib><creatorcontrib>Trauner, Michael</creatorcontrib><creatorcontrib>Püspök, Andreas</creatorcontrib><creatorcontrib>Austrian Biliary RFA Study Group</creatorcontrib><creatorcontrib>for the Austrian Biliary RFA Study Group</creatorcontrib><title>Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Biliary radiofrequency ablation (RFA) using the Habib™ EndoHBP catheter is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to assess the feasibility and safety of this technique.
Methods
In this nationwide retrospective study of prospectively collected clinical data, all patients treated by biliary RFA in Austria between November 2010 and December 2012 were included. Procedure-related complications, adverse events within 30 days post-intervention, stent patency, and mortality rates were investigated.
Results
A total of 58 patients (31 male, 27 female, median age 75 years) underwent 84 RFA procedures at 11 Austrian referral centers for biliary endoscopy. The predominant underlying condition was Klatskin tumor (45 of 58 cases). All 84 RFA procedures were feasible without technical problems. A partial liver infarction was induced by RFA in a 49-year-old Klatskin tumor patient. During 30 days after each RFA procedure, five cases of cholangitis, three cases of hemobilia, two cases of cholangiosepsis, and one case each of gallbladder empyema, hepatic coma, and newly diagnosed left bundle branch block occurred. Median stent patency after last electively performed RFA was 170 days (95 % CI 63–277) and was almost significantly different between metal and plastic stenting (218 vs. 115 days;
p
= 0.051). Median survival was 10.6 months (95 % CI 6.9–14.4) from the time of the first RFA in each patient and 17.9 months (95 % CI 10.3–25.6) from the time of initial diagnosis.
Conclusions
Except for one severe interventional complication (hepatic infarct), RFA presented as a technically feasible and safe therapeutic option for the palliative treatment of malignant biliary obstruction. The good results of stent patency and survival in this study should be proven in prospective (controlled) trials to further quantify the efficacy of this promising new technique.</description><subject>Abdominal Surgery</subject><subject>Ablation</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Animals</subject><subject>Austria - epidemiology</subject><subject>Bile Duct Neoplasms - complications</subject><subject>Bile Duct Neoplasms - diagnosis</subject><subject>Bile ducts</subject><subject>Catheter Ablation - instrumentation</subject><subject>Catheters</subject><subject>Cats</subject><subject>Cholangiocarcinoma</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - methods</subject><subject>Cholangitis</subject><subject>Cholestasis - diagnosis</subject><subject>Cholestasis - etiology</subject><subject>Cholestasis - surgery</subject><subject>Endoscopy</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Palliative Care - methods</subject><subject>Patients</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Quality of life</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Surgery</subject><subject>Surgery, Computer-Assisted - methods</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Tumors</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc9qFTEUxoNY7G3rA7iRgBs3Y_NvZm7cSalVKHTTfUhOTkrK3GRMZpQ-gO9t7r1VRHCVkPP7vnNOPkLecPaBMzZeVsbUoDrGZSeFFJ1-QTZctYsQfPuSbJiWrBOjVqfkrNZH1nDN-1fkVCiuh16NG_LzOvlcIc8RaLE-5lDw24oJnqh1k11iTjTkQnd2ig_JpoW6OEVbnmh2dSkr7ImP1NJ0YH9Ej7TgUnKdsdW-I63L6hsd6FZRyKkirId3O89ThIOqXpCTYKeKr5_Pc3L_-fr-6kt3e3fz9erTbQdyFEs3sNDzISjlkYNX1rngvEQ59g6U0k4oFB4GqyVCb0c3DOA9l4xjgABWnpP3R9u55LZkXcwuVsBpsgnzWg3vGd_KkUne0Hf_oI95LakNt6eY5myUfaP4kYK2cC0YzFzirv2O4czsIzLHiEyLyOwjMrpp3j47r26H_o_idyYNEEegtlJ6wPJX6_-6_gIFSKAr</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Dolak, Werner</creator><creator>Schreiber, Florian</creator><creator>Schwaighofer, Hubert</creator><creator>Gschwantler, Michael</creator><creator>Plieschnegger, Wolfgang</creator><creator>Ziachehabi, Alexander</creator><creator>Mayer, Andreas</creator><creator>Kramer, Ludwig</creator><creator>Kopecky, Andreas</creator><creator>Schrutka-Kölbl, Christiane</creator><creator>Wolkersdörfer, Gernot</creator><creator>Madl, Christian</creator><creator>Berr, Frieder</creator><creator>Trauner, Michael</creator><creator>Püspök, Andreas</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140301</creationdate><title>Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications</title><author>Dolak, Werner ; Schreiber, Florian ; Schwaighofer, Hubert ; Gschwantler, Michael ; Plieschnegger, Wolfgang ; Ziachehabi, Alexander ; Mayer, Andreas ; Kramer, Ludwig ; Kopecky, Andreas ; Schrutka-Kölbl, Christiane ; Wolkersdörfer, Gernot ; Madl, Christian ; Berr, Frieder ; Trauner, Michael ; Püspök, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-60f516f44de1cd4abbfbd3e375bc449b24e2dc6a93ec5a7b66cdd1301efcfca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abdominal Surgery</topic><topic>Ablation</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Animals</topic><topic>Austria - epidemiology</topic><topic>Bile Duct Neoplasms - complications</topic><topic>Bile Duct Neoplasms - diagnosis</topic><topic>Bile ducts</topic><topic>Catheter Ablation - instrumentation</topic><topic>Catheters</topic><topic>Cats</topic><topic>Cholangiocarcinoma</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - methods</topic><topic>Cholangitis</topic><topic>Cholestasis - diagnosis</topic><topic>Cholestasis - etiology</topic><topic>Cholestasis - surgery</topic><topic>Endoscopy</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Internal medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Palliative Care - methods</topic><topic>Patients</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Quality of life</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Surgery</topic><topic>Surgery, Computer-Assisted - methods</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dolak, Werner</creatorcontrib><creatorcontrib>Schreiber, Florian</creatorcontrib><creatorcontrib>Schwaighofer, Hubert</creatorcontrib><creatorcontrib>Gschwantler, Michael</creatorcontrib><creatorcontrib>Plieschnegger, Wolfgang</creatorcontrib><creatorcontrib>Ziachehabi, Alexander</creatorcontrib><creatorcontrib>Mayer, Andreas</creatorcontrib><creatorcontrib>Kramer, Ludwig</creatorcontrib><creatorcontrib>Kopecky, Andreas</creatorcontrib><creatorcontrib>Schrutka-Kölbl, Christiane</creatorcontrib><creatorcontrib>Wolkersdörfer, Gernot</creatorcontrib><creatorcontrib>Madl, Christian</creatorcontrib><creatorcontrib>Berr, Frieder</creatorcontrib><creatorcontrib>Trauner, Michael</creatorcontrib><creatorcontrib>Püspök, Andreas</creatorcontrib><creatorcontrib>Austrian Biliary RFA Study Group</creatorcontrib><creatorcontrib>for the Austrian Biliary RFA Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dolak, Werner</au><au>Schreiber, Florian</au><au>Schwaighofer, Hubert</au><au>Gschwantler, Michael</au><au>Plieschnegger, Wolfgang</au><au>Ziachehabi, Alexander</au><au>Mayer, Andreas</au><au>Kramer, Ludwig</au><au>Kopecky, Andreas</au><au>Schrutka-Kölbl, Christiane</au><au>Wolkersdörfer, Gernot</au><au>Madl, Christian</au><au>Berr, Frieder</au><au>Trauner, Michael</au><au>Püspök, Andreas</au><aucorp>Austrian Biliary RFA Study Group</aucorp><aucorp>for the Austrian Biliary RFA Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2014-03-01</date><risdate>2014</risdate><volume>28</volume><issue>3</issue><spage>854</spage><epage>860</epage><pages>854-860</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Biliary radiofrequency ablation (RFA) using the Habib™ EndoHBP catheter is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to assess the feasibility and safety of this technique.
Methods
In this nationwide retrospective study of prospectively collected clinical data, all patients treated by biliary RFA in Austria between November 2010 and December 2012 were included. Procedure-related complications, adverse events within 30 days post-intervention, stent patency, and mortality rates were investigated.
Results
A total of 58 patients (31 male, 27 female, median age 75 years) underwent 84 RFA procedures at 11 Austrian referral centers for biliary endoscopy. The predominant underlying condition was Klatskin tumor (45 of 58 cases). All 84 RFA procedures were feasible without technical problems. A partial liver infarction was induced by RFA in a 49-year-old Klatskin tumor patient. During 30 days after each RFA procedure, five cases of cholangitis, three cases of hemobilia, two cases of cholangiosepsis, and one case each of gallbladder empyema, hepatic coma, and newly diagnosed left bundle branch block occurred. Median stent patency after last electively performed RFA was 170 days (95 % CI 63–277) and was almost significantly different between metal and plastic stenting (218 vs. 115 days;
p
= 0.051). Median survival was 10.6 months (95 % CI 6.9–14.4) from the time of the first RFA in each patient and 17.9 months (95 % CI 10.3–25.6) from the time of initial diagnosis.
Conclusions
Except for one severe interventional complication (hepatic infarct), RFA presented as a technically feasible and safe therapeutic option for the palliative treatment of malignant biliary obstruction. The good results of stent patency and survival in this study should be proven in prospective (controlled) trials to further quantify the efficacy of this promising new technique.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24196547</pmid><doi>10.1007/s00464-013-3232-9</doi><tpages>7</tpages></addata></record> |
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| ispartof | Surgical endoscopy, 2014-03, Vol.28 (3), p.854-860 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Ablation Adult Aged Aged, 80 and over Animals Austria - epidemiology Bile Duct Neoplasms - complications Bile Duct Neoplasms - diagnosis Bile ducts Catheter Ablation - instrumentation Catheters Cats Cholangiocarcinoma Cholangiopancreatography, Endoscopic Retrograde - methods Cholangitis Cholestasis - diagnosis Cholestasis - etiology Cholestasis - surgery Endoscopy Equipment Design Female Follow-Up Studies Gastroenterology Gynecology Hepatology Humans Incidence Internal medicine Male Medicine Medicine & Public Health Middle Aged Mortality Palliative Care - methods Patients Postoperative Complications - epidemiology Proctology Quality of life Retrospective Studies Stents Surgery Surgery, Computer-Assisted - methods Survival Rate - trends Time Factors Tumors |
| title | Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications |
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