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Volume 7
OMICS Journal of Radiology
Radiology and Oncology 2018
July 16-17, 2018
July 16-17, 2018 Dubai, UAE
Radiology and Oncology
2
nd
World Congress on
Re-establishing patency of occluded metallic biliary stents by endobiliary-RF ablation technique
Bhatnagar Shorav and Sharma Gagan
QRG Central Hospital & Research Centre, India
Background &Aim:
Biliary drainage with the use of Metallic Biliary Stents (MBS) is a well-accepted palliative therapy for patients
with unresectable malignant hilar obstruction. These stents often lose their patency over a period of 6-9 months secondary to
tumor ingrowth or overgrowth, epithelial hyperplasia. Occlusion caused by sludge deposition or clot or stone formation. Limited
treatment options are available for such a condition. Endobiliary Radio Frequency Ablation (RFA) has been shown to be an effective
modality in the treatment of malignant biliary obstruction. Here we present our experience with endobiliary RFA technique for
restoring the patency of occluded MBS.
Method:
Patients were taken with previously placedMBS for malignant etiology, presented with rising serumbilirubin and signs of
cholangitis secondary to occlusion of MBS. Percutaneous trans-hepatic biliary drainage was achieved in all cases. After negotiating
guide-wire across the stent, biliary drainage was established. After treating cholangitis, endobiliary-RFAwas performed. Post-procedure
cholangiogramwas performed to ascertain the patency. Periodic clinical follow-up was scheduled for 6-months or till their survival.
Result:
The patients were followed up clinically and with USG to a minimum of 6 months or till their survival. The presence of
pneumobilia on USG along with normal LFT were considered as the signs of stent patency. All patients showed restoration of
patency on cholangiography examination performed on the following day of RFA (restored diameter 6-8 mm). The mean duration
of stent patency after the first session of RFA was 3.9 months (range 2-7 months) which was comparable to the primary patency of
these stents (4.8 months). This extended period of stent patency ensured administration of additional cycles of chemotherapy in
these patients coupledwith objective improvement in the quality of life. Progressive tumor in growth through the openings between
the struts of the stents can lead to stent block, thereby significantly reducing their primary patency. Till date little progress has been
made in terms of improving the duration of stent patency formalignant strictures. Endobiliary RF ablation is a recently developed option
in the management of such patients. Stent patency achieved after RFA is comparable to the primary patency of biliary stents.
Conclusion:
Our experience suggests that endobiliary-RFA with balloon-sweep maneuver can be a safe and useful technique for
re-establishing the patency of occluded MBS. Re-opened stent with good short term patency offers medical oncologist a chance of
administering additional chemotherapy which may improve patient’s survival.
drshorav@yahoo.comOMICS J Radiol 2018, Volume 7
DOI: 10.4172/2167-7964-C1-022