Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2024; 12(17): 2983-2988
Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.2983
Efficacy and safety of percutaneous transhepatic biliary radiofrequency ablation in patients with malignant obstructive jaundice
Ying Xing, Zheng-Rong Liu, You-Guo Li, Hong-Yi Zhang
Ying Xing, Zheng-Rong Liu, You-Guo Li, Hong-Yi Zhang, Department of General Surgery, Tiantan Hospital, Beijing 100170, China
Author contributions: Xing Y and Liu ZR wrote the manuscript; Xing Y and Zhang HY performed the research; Liu ZR and Li YG designed the research study; All authors have read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Beijing Tiantan Hospital, Approval No. KYSQ 2020-177-01.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Yi Zhang, MD, Surgeon, Department of General Surgery, Tiantan Hospital, No. 119 Fanyang Street, Beijing 100170, China. zhy13910433778@163.com
Received: December 24, 2023
Revised: April 18, 2024
Accepted: May 6, 2024
Published online: June 16, 2024
Processing time: 163 Days and 1.5 Hours
Abstract
BACKGROUND

Percutaneous transhepatic cholangiodrainage (PTCD) and endoscopic retrograde cholangiopancreatography/endoscopic nasobiliary drainage are the most common clinical procedures for jaundice control in patients with unresectable malignant obstructive jaundice, yet the safety and effect of endobiliary radiofrequency ablation (EB-RFA) combined PTCD is rarely reported, in this article, we report our experience of EB-RFA combined PTCD in such patients.

AIM

To retrospectively study the efficacy and safety of EB-RFA combined PTCD in patients with unresectable malignant obstructive jaundice.

METHODS

Patients with unresectable malignant obstructive jaundice treated with EB-RFA under PTCD were selected, the bile ducts of the right posterior lobe was selected as the target bile ducts in all cases. The general conditions of all patients, preoperative tumour markers, total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB), alkaline phosphatase (ALP), and glutamyl transferase (GGT) before and on the 7th day after the procedure, as well as perioperative complications, stent patency time and patient survival were recorded.

RESULTS

All patients successfully completed the operation, TBIL and DBIL decreased significantly in all patients at the 7th postoperative day (P = 0.009 and 0.006, respectively); the values of ALB, ALP and GGT also decreased compared with the preoperative period, but the difference was not statistically significant. Perioperative biliary bleeding occurred in 2 patients, which was improved after transfusion of blood and other conservative treatments, pancreatitis appeared in 1 patient after the operation, no serious complication and death happened after operation. Except for 3 patients with loss of visits, the stent patency rate of the remaining 14 patients was 100% 71% and 29% at the 1st, 3rd, and 6th postoperative months respectively, with a median survival of 4 months.

CONCLUSION

EB-RFA under PTCD in patients with unresectable malignant obstructive jaundice has a satisfactory therapeutic effect and high safety, which is worthy of further clinical practice.

Keywords: Biliary tract tumour, Malignant obstructive jaundice, Percutaneous transhepatic cholangiodrainage, Endoluminal radiofrequency ablation, Biliary radiofrequency ablation

Core Tip: Studied the efficacy and safety of endobiliary radiofrequency ablation using percutaneous transhepatic cholangiodrainage in 17 patients with malignant obstructive jaundice, all patients successfully completed the operation, total bilirubin and direct bilirubin decreased significantly after operation; perioperative biliary bleeding occurred in 2 patients, which was improved after transfusion of blood and other conservative treatments, pancreatitis appeared in 1 patient after the operation, and was improved by medication; during follow-up, the stent patency rate was 100% 71% and 29% at the 1st, 3rd, and 6th postoperative months respectively, with a median survival of 4 months.