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Endoluminal ablation for malignant biliary duct stenosis



Druh Další prezentace na konferencích
Fakulta / Pracoviště MU

Lékařská fakulta

Popis Learning Objectives Endoluminal radiofrequency ablation is a useful palliative method for patients with malignant stenosis of the bile ducts. It can be used for ablation before self-expandable metal stent placement and in dealing with stent occlusion. Thermal injuries of the bile ducts and surrounding vasculature are possible complications. Background The optimal palliative method for patients with bile duct malignancies is metal stent placement. The use of covered self-expanding stents does not seem to be an appropriate solution for resolving hilar strictures. However, the most frequent complication of uncovered self-expandable metal stents is their closure. To prolong metal stent patency, photodynamic techniques and brachytherapy are used. Nowadays, endoluminal radiofrequency ablation is another possibility. Clinical Findings/Procedure After the endoluminal ablation procedure, a lower rate of stent occlusion and early stent occlusion (up to 2 months of stent placement) is found. In addition, the intervention is not associated with higher rates of complications compared with brachytherapy or photodynamic therapy. In ex vivo testing using thermometric and thermographic studies, we propose an optimal protocol of ablation for the clearance of occluded stents considering patient safety. Conclusion Local ablation techniques such as endoluminal radiofrequency ablation with simple and one-time application are potentially useful in palliating endoluminal tumours, preventing early ingrowth of the tumours through the stent mesh and even helping to resolve stent occlusion. However, there are still no randomised, prospective studies for these applications. The work was supported by grant from the Ministry of Health of the Czech Republic (NT14586).
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