Clinical value of SpyGlass direct visualization system-guided radiofrequency ablation combined with biliary stent implantation in the treatment of malignant biliary strictures
10.3760/cma.j.cn113884-20240419-00112
- VernacularTitle:SpyGlass下姑息性射频消融联合置入胆管支架治疗胆管恶性狭窄的疗效分析
- Author:
Lili ZHANG
1
;
Jingbin NI
;
Yonghua SHEN
;
Lei GONG
Author Information
1. 无锡市第二人民医院（江南大学附属中心医院）消化内科，无锡 214002
- Keywords:
Ablation techniques;
SpyGlass;
Malignant biliary stricture
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(9):662-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical value of SpyGlass direct visualization system-guided radiofrequency ablation (RFA) combined with biliary stent implantation in the treatment of malignant biliary stricture.Methods:Clinical data of 29 patients with advanced malignant biliary stricture without surgical resectability who received palliative endoscopic treatment in Drum Tower Hospital of Nanjing University Medical School and Wuxi No.2 People’s Hospital were retrospectively analyzed, including 20 males and 9 females, aged (70.3±11.5) years. Patients were divided into two groups: the SpyGlass-guided biliary RFA combined with biliary stent implantation treatment group (combined group, n=14) and the simple biliary stent treatment group (simple stent group, n=15). The age, gender, body mass index (BMI), the total bilirubin, jaundice remission, postoperative complications, stent patency time and survival period were compared between the two groups. Results:Among 29 cases, 20 were cholangiocarcinoma (69.0%), 4 were hepatocellular carcinoma (13.8%), 3 were carcinoma of gallbladder (10.3%), and 2 were ampullary carcinoma (6.9%). There were no statistically significant difference in age, male proportion, primary tumor proportion, BMI and total bilirubin between the groups (all P>0.05). The postoperative total bilirubin of the combined group was 41.5(29.8, 52.5)μmol/L, and that of the stent group was 55.4(31.5, 107.1)μmol/L ( Z=1.18, P=0.247). There were 11 cases of jaundice remission in the combined group and 10 in the stent group ( χ2=0.51, P=0.474). The stent patency time in the combined group was 90 (77, 250) days, and that in the stent group was 100 (60, 190) days ( Z=0.28, P=0.793). There was no significant difference in cumulative survival rates and incidence of postoperative complications between the two groups ( P>0.05). Conclusion:SpyGlass-guided biliary RFA combined with biliary stent implantation neither improves the treatment efficacy nor prolongs stent patency time in patients with malignant biliary strictures.
