Percutaneous Intraductal Microwave Ablation of Malignant Biliary Strictures: Initial Experience

Uyanık, Sadık Ahmet; Öğüşlü, Umut; Yılmaz, Birnur; Çevik, Halime; Atlı, Eray; Gümüş, Burçak

doi:10.2214/ajr.19.21897

Cited by 10 publications

(7 citation statements)

References 39 publications

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“…Uyanık et al studied the use of MWA in the management of malignant biliary strictures. 44 They performed a retrospective study that included 12 patients who had undergone intraductal MWA with metallic stent placement for malignant biliary strictures over a period of 9 months. The causes of malignant biliary obstruction in these patients were pancreatic carcinoma in four patients, gastric antrum carcinoma in three, cholangiocarcinoma in two, metastasis in two, and gallbladder carcinoma in one patient.…”

Section: Discussionmentioning

confidence: 99%

A Review of Direct Endobiliary Techniques for the Management of Biliary Conditions

Garg

Singh

Weiss

2022

Digestive Disease Interventions

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A majority of patients with cholangiocarcinoma and malignant biliary obstruction cannot undergo surgery for treatment as they present late in the disease course. It is crucial to relieve biliary obstruction in these conditions, for which metallic stents are commonly used. However, these stents have a high rate of occlusion due to the ingrowth of malignant tissue. In this review, we will discuss the use of direct endobiliary therapies that can be used either independently or in combination with metallic stents.

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Section: Discussionmentioning

confidence: 99%

A Review of Direct Endobiliary Techniques for the Management of Biliary Conditions

Garg

Singh

Weiss

2022

Digestive Disease Interventions

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“…The final analysis included 15 studies, 6 of which were RCTs 13,15,17,22,23,25 and 9 of which were prospective OS. 11,12,14,16,[18][19][20][21]24 The remaining 19 articles were eliminated because they were review articles, missing required outcome, animal studies, and single-arm studies (Fig. 2).…”

Section: Search Outcome Characteristic and Assessment Of Studiesmentioning

confidence: 99%

Efficacy and Safety of Radiofrequency Ablation Plus Stent Versus Stent-alone Treatments for Malignant Biliary Strictures

Khizar

et al. 2022

Journal of Clinical Gastroenterology

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Background/Aims: Malignant biliary strictures (MBS) are very aggressive and cannot be diagnosed in the early stages due to their asymptomatic nature. Stenting the stricture area of the biliary tree is palliative treatment but has poor survival time. Radiofrequency ablation plus stent (RFA+S) have been recently used to improve the survival and stent patency time in patients with MBS. In this systematic review and meta-analysis, we tried to evaluate the efficacy and safety of radiofrequency ablation. Materials and Methods: Study search up to December 2021 was performed in different medical databases such as PubMed, Web of Science, and Cochrane library, etc. We selected eligible studies reporting survival time, stent patency time, and adverse events in patients with MBS. We compare the outcomes of RFA+S and stent-alone treatment groups. Results: A total of 15 studies (6 randomized controlled trials and 9 observational studies) with 1815 patients were included for meta-analysis of which 701 patients were in RFA+S group and 1114 patients in the stent-alone group. Pooled mean difference of survival time was 2.88 months (95% CI: 1.78-3.97) and pooled mean difference of stent patency time was 2.11 months (95% CI: 0.91-3.30) and clinical success risk ratio was 1.05 (95% CI: 1.01–1.09). Risk ratios for adverse events are given; Bleeding 0.84 (95% CI: 0.34-2.11), abdominal pain 1.06 (95% CI: 0.79-1.40), pancreatitis 0.93 (95% CI: 0.43-2.01), cholangitis 1.07 (95% CI: 0.72-1.59), and stent dysfunction 0.87 (95% CI: 0.70-1.07). Conclusions: Radiofrequency ablation is involved in increased survival and stent patency time for MBS patients. With the help of better techniques, adverse events can be limited.

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“…In the future, other techniques, such as microwave ablation and irreversible electroporation may prove to be interesting candidates for endoluminal tumor therapy (24,25). Given the fact that the integration of endoluminal RFA into clinical practice required decades to achieve, immense efforts are warranted for standards to be set in this field.…”

Section: Power Setting Generator Used With ----------------------------------------------------------------------------------------------mentioning

confidence: 99%

Comparison of four endoluminal radiofrequency ablation devices and four power generators in an ex vivo bovine liver model

et al. 2021

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The aim of the present study was to investigate the ex vivo results of four different endoluminal bipolar radiofrequency ablation (RFA) probes at different energy settings and using four different power generators. Ex vivo RFA was performed on bovine liver using four different bipolar RFA probes: i) Habib™ EndoHPB (EMcision); ii) Habib™ VesOpen (EMcision); iii) Celon ProCurve micro 300-C09 (Olympus Corporation); and iv) Celon ProCurve 1200 S15 (Olympus Corporation). The following generators were also used: Erbe Vio 300D, KLS Martin Maxium, Olympus CelonPOWER and Boston RF3000. Overall, 430 ablations were carried out. The results revealed significant differences in the size of the achieved lesions and the duration of ablation (P<0.05) between the four different ablation devices. The maximum lesion diameters achieved with the devises were as follows: HabibTM EndoHPB, 13 watts (W; mean ± standard deviation, 10.3±1.8 mm); Habib™ VesOpen, 12 W (11.3±0.6); Celon ProCurve micro, 2 W (7.9±2.2); and Celon ProCurve 1200, 10 W (9.2±1.1). The maximum lesion diameters induced by the various generators differed significantly. On the whole, the present study demonstrates that lesion size and ideal power settings vary between different endoluminal ablation devices and generators. The combination of the probe and generator should not be varied in clinical practice to ensure reliable results.

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Percutaneous Intraductal Microwave Ablation of Malignant Biliary Strictures: Initial Experience

Cited by 10 publications

References 39 publications

A Review of Direct Endobiliary Techniques for the Management of Biliary Conditions

A Review of Direct Endobiliary Techniques for the Management of Biliary Conditions

Efficacy and Safety of Radiofrequency Ablation Plus Stent Versus Stent-alone Treatments for Malignant Biliary Strictures

Comparison of four endoluminal radiofrequency ablation devices and four power generators in an ex vivo bovine liver model

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