Endoluminal ablation for malignant biliary duct stenosis

k 2014

Endoluminal ablation for malignant biliary duct stenosis

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

Základní údaje

Originální název

Endoluminal ablation for malignant biliary duct stenosis

Autoři

ANDRAŠINA, Tomáš (703 Slovensko, garant, domácí), Vladan BERNARD (203 Česká republika, domácí), Jiří PÁNEK (203 Česká republika, domácí), Jan HLAVSA (203 Česká republika, domácí), Jaroslav BOUDNÝ (203 Česká republika, domácí) a Vlastimil VÁLEK (203 Česká republika, domácí)

Vydání

CIRSE 2014, 2014

Další údaje

Jazyk

angličtina

Typ výsledku

Prezentace na konferencích

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Kód RIV

RIV/00216224:14110/14:00087434

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

biliary ablation; malignancy

Štítky

EL OK

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

Anotace

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).

Návaznosti

NT14586, projekt VaV

Název: Choledochoskopem navigovaná radiofrekvenční ablace žlučových cest.

Investor: Ministerstvo zdravotnictví ČR, Choledochoskopem navigovaná radiofrekvenční ablace žlučových cest.

Citovat

ANDRAŠINA, Tomáš, Vladan BERNARD, Jiří PÁNEK, Jan HLAVSA, Jaroslav BOUDNÝ a Vlastimil VÁLEK. Endoluminal ablation for malignant biliary duct stenosis. In CIRSE 2014. 2014.

@proceedings{1216264,
   author = {Andrašina, Tomáš and Bernard, Vladan and Pánek, Jiří and Hlavsa, Jan and Boudný, Jaroslav and Válek, Vlastimil},
   booktitle = {CIRSE 2014},
   keywords = {biliary ablation; malignancy},
   language = {eng},
   title = {Endoluminal ablation for malignant biliary duct stenosis},
   year = {2014}
}

TY  - CONF
ID  - 1216264
AU  - Andrašina, Tomáš - Bernard, Vladan - Pánek, Jiří - Hlavsa, Jan - Boudný, Jaroslav - Válek, Vlastimil
PY  - 2014
TI  - Endoluminal ablation for malignant biliary duct stenosis
KW  - biliary ablation
KW  - malignancy
N2  - 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).
ER  -

ANDRAŠINA, Tomáš, Vladan BERNARD, Jiří PÁNEK, Jan HLAVSA, Jaroslav BOUDNÝ a Vlastimil VÁLEK. Endoluminal ablation for malignant biliary duct stenosis. In \textit{CIRSE 2014}. 2014.

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