k 2014

Endoluminal ablation for malignant biliary duct stenosis

ANDRAŠINA, Tomáš, Vladan BERNARD, Jiří PÁNEK, Jan HLAVSA, Jaroslav BOUDNÝ et. al.

Basic information

Original name

Endoluminal ablation for malignant biliary duct stenosis

Authors

ANDRAŠINA, Tomáš (703 Slovakia, guarantor, belonging to the institution), Vladan BERNARD (203 Czech Republic, belonging to the institution), Jiří PÁNEK (203 Czech Republic, belonging to the institution), Jan HLAVSA (203 Czech Republic, belonging to the institution), Jaroslav BOUDNÝ (203 Czech Republic, belonging to the institution) and Vlastimil VÁLEK (203 Czech Republic, belonging to the institution)

Edition

CIRSE 2014, 2014

Other information

Language

English

Type of outcome

Prezentace na konferencích

Field of Study

30000 3. Medical and Health Sciences

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/14:00087434

Organization unit

Faculty of Medicine

Keywords in English

biliary ablation; malignancy

Tags

Změněno: 30/4/2015 14:56, Ing. Mgr. Věra Pospíšilíková

Abstract

V originále

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).

Links

NT14586, research and development project
Name: Choledochoskopem navigovaná radiofrekvenční ablace žlučových cest.
Investor: Ministry of Health of the CR