经皮胆道内射频消融治疗胆道支架狭窄的初步研究

Percutaneous intraductal radiofrequency ablation for the treatment of biliary stent stenosis: a preliminary study

目的采用经皮胆道射频消融（RFA）方法，治疗胆道支架狭窄，探讨该方法的可行性和有效性。方法选取43例因胆道支架狭窄引起胆道梗阻患者，用经皮肝穿刺胆道的方法，将EndoHPB导管放置于胆道支架狭窄处行RFA治疗，术后留置胆道引流管，经造影确认支架通畅后拔除引流管。结果术后所有患者经胆道造影证实胆道支架通畅，无相关并发症发生，存活患者狭窄支架的再通畅时间中位数为107d（12-180d）。结论经初步临床应用表明经皮胆道内RFA对胆道支架狭窄的治疗具有良好的疗效和安全性，但仍需有效的随机对照试验来进一步证实。

Objective To evaluate the feasibility and effectiveness of percutaneous intraductal radiofrequency ablation （RFA） in treating biliary stent stenosis. Methods A total of 43 cases with biliary obstruction caused by biliary stent stenosis were enrolled in this study. Through percutaneous transhepatic pucturing of biliary duct, an EndoHPB catheter was placed in the stenotic site of the biliary stent, which was followed by RFA treatment. After RFA, biliary drainage catheter was reserved. The drainage catheter was removed when angiography confirmed that the stent was patent. Results Cholangiography showed that the biliary stent became patency after RFA in all patients. No procedure- related complications occurred. After RFA, the median patency time of the stenotic biliary stent in survival patients was 107 days （12-180 days）. Conclusion The results of this preliminary clinical study indicate that percutaneous intraductal radiofrequency ablation has excellent effect and safety for the treatment of biliary stent stenosis, although more reliable and randomized controlled trials are needed before its effect and safety can be further proved.