经内镜逆行胰胆管造影联合腔内射频消融在恶性胆道梗阻治疗中的应用

王健铭; 梁晋尧; 罗诗樵

doi:10.3969/j.issn.1001-5256.2019.05.050

经内镜逆行胰胆管造影联合腔内射频消融在恶性胆道梗阻治疗中的应用

DOI: 10.3969/j.issn.1001-5256.2019.05.050

重庆医科大学附属第一医院肝胆外科

基金项目:

重庆市基础与前沿研究计划项目(cstc2013jcyjA10105)；

详细信息

中图分类号: R730.5
计量
- 文章访问数: 1245
- HTML全文浏览量: 33
- PDF下载量: 287
- 被引次数: 0
出版历程
- 收稿日期: 2018-11-23
- 出版日期: 2019-05-20

Assessment of endoscopic retrograde cholangiopancreatography combined with intraductal radiofrequency ablation in treatment of malignant biliary obstruction

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University

Research funding:

摘要

摘要: 恶性胆道梗阻一经临床诊断往往已到中晚期,姑息性解除梗阻成为主要的治疗选择。胆道支架植入是目前运用最多的缓解胆道梗阻的治疗方式,但支架再次梗阻是临床中经常面临的问题,经内镜逆行胰胆管造影联合腔内射频消融治疗恶性胆道梗阻可解决直接梗阻问题,其可延长支架通畅率以及患者的生存时间、生存率,且并发症少,手术相关病死率低,可作为治疗恶性胆道梗阻一种安全可行的姑息性选择。
- 胆道疾病 /
- 胰胆管造影术,内窥镜逆行 /
- 导管消融术 /
- 综述
Abstract: Malignant biliary obstruction is often in an advanced stage at the time of diagnosis, and palliative relief of obstruction has become the main treatment option. Biliary stent implantation is currently the most widely used treatment for the relief of biliary obstruction, but stent reobstruction has become a common problem in clinical practice. Endoscopic retrograde cholangiopancreatography ( ERCP) combined with intraductal radiofrequency ablation can solve the problem of direct obstruction in malignant biliary obstruction and improve stent patency rate, survival time, and survival rate, with few complications and a low surgery-related mortality rate, and therefore, it can be used as a safe and feasible palliative treatment method for malignant biliary obstruction.
- biliary tract diseases /
- cholangiopancreatography, endoscopic retrograde /
- catheter ablation /
- review

HTML全文

参考文献(38)

[1] WANG Q, ZHAO LS, KE YJ, et al. Short-term efficacy observation and influencing factor analysis of percutaneous transhepatic biliary drainage in treatment of malignant obstructive jaundice[J]. Med Pharm J Chin PLA, 2016, 28 (2) :55-58. (in Chinese) 王强, 赵丽莎, 柯要军, 等.经皮肝穿刺胆管引流术治疗恶性梗阻性黄疸近期效果观察及影响因素分析[J].解放军医药杂志, 2016, 28 (2) :55-58.

[2] ZHANG K, LI Y, XIE ZB, et al. Curative efficacy and prognosis of radiofrequency ablation in combination with stent placement guided by endoscopic retrograde cholangio-pancreatography in patients of bile duct cancer complicated with obstruction[J]. China J Modern Med, 2016, 26 (12) :107-111. (in Chinese) 张锎, 李芸, 谢朝波, 等.经内镜逆行性胰胆管造影术引导下腔内射频消融联合内支架置入治疗恶性胆管肿瘤合并梗阻的疗效及预后分析[J].中国现代医学杂志, 2016, 26 (12) :107-111.

[3] CHEN BY, PANG LY. Compative study of biliary metallic stent implantation via ERCP and PTCD approaches in treatment of malignant obstructive jaundice[J]. Chin J Bases and Clin Gen Surg, 2016, 23 (8) :967-971. (in Chinese) 陈保银, 庞林元. ERCP和PTCD途径胆管金属支架置入治疗恶性梗阻性黄疸的对比研究[J].中国普外基础与临床杂志, 2016, 23 (8) :967-971.

[4] WANG H, WANG T, TANG LJ. Application of of interventional imaging technology to treatment of late porta hepatis bile duct cancer[J]. Clin J Med Offic, 2015, 43 (3) :234-236. (in Chinese) 王华, 汪涛, 汤礼军.介入影像医学技术在晚期肝门胆管癌姑息治疗中的应用价值[J].临床军医杂志, 2015, 43 (3) :234-236.

[5] BENNETT JJ, GREEN RH. Malignant masquerade:Dilemmas in diagnosing biliary obstruction[J]. Surg Oncol Clin N Am, 2009, 18 (2) :207-214.

[6] BOULAY BR, GARDNER TB, GORDON SR. Occlusion rate and complications of plastic biliary stent placement in patients undergoing neoadjuvant chemoradiotherapy for pancreatic cancer with malignant biliary obstruction[J]. J Clin Gastroenterol, 2010, 44 (6) :452-455.

[7] BOULAY BR, PAREPALLY M. Managing malignant biliary obstruction in pancreas cancer:Choosing the appropriate strategy[J]. World J Gastroenterol, 2014, 20 (28) :9345-9353.

[8] MIZANDARI M, KUMAR J, PAI M, et al. Interventional radiofrequency ablation:A promising therapeutic modality in the management of malignant biliary and pancreatic duct obstruction[J]. J Cancer, 2018, 9 (4) :629-637.

[9] WANG S, ZHANG GL. Evaluation of radiofrequency ablation combined with metal stent in the treatment of malignant biliary obstruction[J]. J Hepatopancreatobiliary Surg, 2016, 28 (6) :496-498. (in Chinese) 王胜, 张国雷.射频消融联合金属支架治疗恶性胆管梗阻疗效评价[J].肝胆胰外科杂志, 2016, 28 (6) :496-498.

[10] ZHAO HG, XU J, YIN M, et al. Analysis of laparotomic and endoscopic biliary stent placements treating advanced malignant obstructive jaundice[J]. China Med, 2016, 11 (9) :1333-1337. (in Chinese) 赵会庚, 徐键, 尹敏, 等.开腹与内镜下胆道内支架置入治疗晚期恶性梗阻性黄疸的对比分析[J].中国医药, 2016, 11 (9) :1333-1337.

[11] XIE YH, WANG Q, LI R, et al. Clinical efficacy of percutaneous transhepatic biliary drainage parallel intraductal radiofrequency ablation combined with in-traductal stent in the treatment of hilar cholangiocarcinoma with malignant obstruction[J]. Clin J Med Offic, 2017, 45 (9) :894-897. (in Chinese) 谢应海, 王琦, 李瑞, 等.经皮肝穿刺胆管腔内射频消融联合植入支架治疗肝门胆管癌伴恶性梗阻临床疗效研究[J].临床军医杂志, 2017, 45 (9) :894-897.

[12] SUN GW, LI HZ, WANG BF, et al. Analysis on diagnosis and treatment of ERCP for 68 patients with malignant obstructive jaundice[J]. J Reg Anat Oper Surg, 2013, 22 (2) :173-175. (in Chinee) 孙广伟, 李华章, 王本锋, 等. 68例恶性梗阻性黄疸患者ERCP诊治的分析[J].局解手术学杂志, 2013, 22 (2) :173-175.

[13] WANG AY, YACHIMSKI PS. Endoscopic management of pancreatobiliary neoplasms[J]. Gastroenterology, 2018, 154 (7) :1947-1963.

[14] LUO DD, QIAO AY. Research advances in radiofrequency ablation in treatment of hepatocellular carcinoma[J]. J Clin Hepatol, 2017, 33 (7) :1358-1361. (in Chinese) 罗丹东, 乔安意.射频消融治疗肝细胞癌的研究进展[J].临床肝胆病杂志, 2017, 33 (7) :1358-1361.

[15] LI Y, HE N, CAO LQ. Research progress of endoscopic treatment for malignant biliary obstruction[J/CD]. Chin Arch General Surg:Electronic Version, 2017, 11 (1) :56-60. (in Chinese) 李越, 何南, 曹良启.内镜治疗恶性胆道梗阻的应用现状[J/CD].中华普通外科学文献:电子版, 2017, 11 (1) :56-60.

[16] PU DL, LIAO JR. Clinical value of CT-guided radioactive seeds125I implantation and radiofrequency ablation (RFA) in the treatment ofⅢ-Ⅳprimary hepatic carcinoma[J]. China J Modern Med, 2014, 24 (30) :104-106. (in Chinese) 蒲德利, 廖江荣. CT引导下射频消融联合125I粒子治疗中晚期原发性肝癌的临床研究[J].中国现代医学杂志, 2014, 24 (30) :104-106.

[17] HU XW, DING TL, HONG ZX. Therapeutic effect of partial hepatectomy combined with radiofrequency ablation for primary hepatocellular carcinoma[J]. Trauma Crit Med, 2018, 6 (4) :226-227, 230. (in Chinese) 胡雄伟, 丁同领, 洪智贤.部分肝切除术联合射频消融术治疗原发性肝癌疗效分析[J].创伤与急危重病医学, 2018, 6 (4) :226-227, 230.

[18] GAO DJ, HU B. Advances in endoscopic radiofrequency ablation for malignant biliary stricture[J]. Chin J Pract Surg, 2017, 37 (8) :925-928. (in Chinese) 高道键, 胡冰.内镜下射频消融术治疗恶性胆道狭窄研究进展[J].中国实用外科杂志, 2017, 37 (8) :925-928.

[19] MENSAH ET, MARTIN J, TOPAZIAN M. Radiofrequency ablation for biliary malignancies[J]. Curr Opin Gastroenterol, 2016, 32 (3) :238-243.

[20] WADSWORTH CA, WESTABY D, KHAN SA. Endoscopic radiofrequency ablation for cholangiocarcinoma[J]. Curr Opin Gastroenterol, 2013, 29 (3) :305-311.

[21] RUSTAGI T, JAMIDAR PA. Intraductal radiofrequency ablation for management of malignant biliary obstruction[J]. Dig Dis Sci, 2014, 59 (11) :2635-2641.

[22] CHO JH, LEE KH, KIM JM, et al. Safety and effectiveness of endobiliary radiofrequency ablation according to the different power and target temperature in a swine model[J]. J Gastroenterol Hepatol, 2017, 32 (2) :521-526.

[23] KHORSANDI SE, ZACHAROULIS D, VAYRA P, et al. The modern use of radiofrequency energy in surgery, endoscopy and interventional radiology[J]. European Surgery, 2008, 40 (5) :204-210.

[24] ITOI T, ISAYAMA H, SOUFUNI A, et al. Evaluation of effects of a novel endoscopically applied radiofrequency ablation biliary catheter using an ex-vivo pig liver[J]. J Hepatobiliary Pancreat Sci, 2012, 19 (5) :543-547.

[25] ZACHAROULIS D, LAZOURA O, SIOKA E, et al. Habib EndoHPB:A novel endobiliary radiofrequency ablation device. An experimental study[J]. J Invest Surg, 2013, 26 (1) :6-10.

[26] ALIS H, SENGOZ C, GONENC M, et al. Endobiliary radiofrequency ablation for malignant biliary obstruction[J]. Hepatobiliary Pancreat Dis Int, 2013, 12 (4) :423-427.

[27] XIE JP, LIANG H, ZHANG DW, et al. Endoscopic radiofrequency ablation combined with metal stent implantation and simple metal stent implan tation forunrespectable[J]. J Pract Med, 2018, 34 (9) :1488-1490. (in Chinese) 谢炬平, 梁浩, 张大伟, 等.内镜下射频消融联合金属支架植入对不可切除胆管癌的疗效[J].实用医学杂志, 2018, 34 (9) :1488-1490

[28] STEEL AW, POSTGATE AJ, KHORSANDI S, et al. Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction[J]. Gastrointest Endosc, 2011, 73 (1) :149-153.

[29] FIGUEROA-BAROJAS P, BAKHRU MR, HABIB NA, et al.Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer:A novel palliation technique[J]. J Oncol, 2013, 2013:910897.

[30] STRAND DS, COSGROVE ND, PATRIE JT, et al. ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma[J]. Gastrointest Endosc, 2014, 80 (5) :794-804.

[31] SHARAIHA RZ, SETHI A, WEAVER KR, et al. Impact of radiofrequency ablation on malignant biliary strictures:Results of a collaborative registry[J]. Dig Dis Sci, 2015, 60 (7) :2164-2169.

[32] WU TT, LI HC, LI WM, et al. Percutaneous intraluminal radiofrequency ablation for malignant extrahepatic biliary obstruction:A safe and feasible method[J]. Dig Dis Sci, 2015, 60 (7) :2158-2163.

[33] DOLAK W, SCHREIBER F, SCHWAIGHOFER H, et al. Endoscopic radiofrequency ablation for malignant biliary obstruction:A nationwide retrospective study of 84 consecutive applications[J]. Surg Endosc, 2014, 28 (3) :854-860.

[34] TAL AO, VERMEHREN J, FRIEDRICHRUST M, et al. Intraductal endoscopic radiofrequency ablation for the treatment of hilar non-resectable malignant bile duct obstruction[J].World J Gastrointest Endosc, 2014, 6 (1) :13.

[35] LAQUIERE A, BOUSTIERE C, LEBLANC S, et al. Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma[J]. Surg Endosc, 2016, 30 (3) :1242-1248.

[36] KALLIS Y, PHILLIPS N, STEEL A, et al. Analysis of endoscopic radiofrequency ablation of biliary malignant strictures in pancreatic cancer suggests potential survival benefit[J]. Dig Dis Sci, 2015, 60 (11) :3449-3455.

[37] ZHANG YF, PAN WK, WU B, et al. Clinical efficacy and short-term prognosis of ercp-guided intracavitary radiofrequency ablation combined with stent implantation in treatment of malignant bile duct tumor associated by obstruction[J]. Med Pharm J Chin PLA, 2017, 29 (9) :48-51. (in Chinese) 张亚飞, 潘伟康, 吴兵, 等. ERCP引导下腔内射频消融联合支架置入治疗恶性胆管肿瘤合并梗阻的临床疗效及短期预后分析[J].解放军医药杂志, 2017, 29 (9) :48-51.

[38] SHARAIHA RZ, NATOV N, GLOCKENBERG KS, et al. Comparison of metal stenting with radiofrequency ablation versus stenting alone for treating malignant biliary strictures:Is there an added benefit?[J]. Dig Dis Sci, 2014, 59 (12) :3099-3102.

施引文献

资源附件(0)

访问统计