Combined Stent Insertion and High-intensity Focused Ultrasound Ablation for Patients With Malignant Obstructive Jaundice

Surg Laparosc Endosc Percutan Tech. 2016 Dec;26(6):488-492. doi: 10.1097/SLE.0000000000000327.

Abstract

Purpose: We aimed to determine the clinical effectiveness of combined stent insertion and high-intensity focused ultrasound (HIFU) ablation for patients with malignant obstructive jaundice (MOJ).

Materials and methods: From June 2013 to May 2015, consecutive patients with inoperable MOJ underwent biliary stent with or without HIFU ablation in our center. Treatment-related complications, stent patency time, and survival time were compared between 2 groups.

Results: During the enrolled time, a total of 51 patients with MOJ underwent biliary stent with HIFU ablation (n=24) or biliary stent only (n=27) in our center. There was no significant difference in baseline data between 2 groups. Relief of jaundice was achieved in all patients in both groups. Cholangitis was observed in 2 patients in stent with HIFU ablation group and 1 patient in stent only group (P=0.483). Reobstruction of stent was observed in 4 patients in stent with HIFU ablation group and 8 patients in stent only group (P=0.276). The mean stent patency time was 367±41 days in stent with HIFU ablation group and 257±35 days in stent only group (P=0.037). The mean overall survival was 238±31 days in stent with HIFU ablation group and 152±20 days in stent only group (P=0.014).

Conclusions: Combined biliary stent insertion and HIFU ablation is a safe and easy method for patients with MOJ, and seems to extend stent patency time and survival when compared with biliary stent only.

MeSH terms

  • Ablation Techniques / methods*
  • Bile Duct Neoplasms / complications
  • Cholangiopancreatography, Magnetic Resonance
  • Female
  • Follow-Up Studies
  • Humans
  • Jaundice, Obstructive / diagnosis
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / surgery*
  • Liver Neoplasms / complications
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / complications
  • Prosthesis Implantation / methods*
  • Retrospective Studies
  • Stents*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonic Surgical Procedures / methods*