PMID- 36220379
OWN - NLM
STAT- MEDLINE
DCOM- 20230126
LR  - 20230522
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 97
IP  - 2
DP  - 2023 Feb
TI  - Endoscopic radiofrequency ablation for ingrowth occlusion after bilateral metal 
      stent placement for malignant hilar biliary obstruction: a prospective pilot 
      study.
PG  - 282-290.e1
LID - S0016-5107(22)02023-5 [pii]
LID - 10.1016/j.gie.2022.09.025 [doi]
AB  - BACKGROUND AND AIMS: Endoscopic biliary radiofrequency ablation (RFA) may be an 
      option for the treatment of ingrowth occlusion after self-expandable metal stent 
      (SEMS) deployment; however, its utility remains uncertain. This study aimed to 
      examine the feasibility of RFA for the palliation of ingrowth after bilateral 
      SEMS placement in patients with malignant hilar biliary obstruction. METHODS: 
      This prospective, single-center, pilot study enrolled 30 patients who met the 
      eligibility criteria between April 2020 and March 2022. Study outcomes were 
      technical success, clinical success, recurrent biliary obstruction (RBO), and 
      adverse events (AEs) besides RBO associated with RFA for ingrowth occlusion. 
      Furthermore, factors predictive of clinical success were evaluated. RESULTS: 
      Technical and clinical success rates were 93.3% (28/30) and 71.4% (20/28), 
      respectively. The rates of early and late AEs were 6.7% (2/30) and 10.0% (2/20), 
      respectively. The incidence rate of RBO after RFA was 45.0% (9/20), and the 
      median time to RBO was 163 days. Multivariate analysis of the factors affecting 
      clinical success revealed a positive association between the recanalization 
      diameter on the ingrown part within the SEMS (odds ratio, 1.13; 95% confidence 
      interval, 1.01-1.26; P = .038). The calculated optimal cutoff for the ratio of 
      the recanalization diameter to the SEMS diameter for predicting clinical success 
      was 51.1%. CONCLUSIONS: Endoscopic biliary RFA elicited promising results, with 
      good long-term stent patency and without the requirement of any additional stent 
      placement, for the palliation of ingrowth occlusion after bilateral SEMS 
      placement. However, the clinical success rate was insufficient, necessitating 
      improvements in the future. (Clinical trial registration number: UMIN000040154.).
CI  - Copyright (c) 2023 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Inoue, Tadahisa
AU  - Inoue T
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Ibusuki, Mayu
AU  - Ibusuki M
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Kitano, Rena
AU  - Kitano R
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Sakamoto, Kazumasa
AU  - Sakamoto K
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Kimoto, Satoshi
AU  - Kimoto S
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Kobayashi, Yuji
AU  - Kobayashi Y
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Sumida, Yoshio
AU  - Sumida Y
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Nakade, Yukiomi
AU  - Nakade Y
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Ito, Kiyoaki
AU  - Ito K
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
FAU - Yoneda, Masashi
AU  - Yoneda M
AD  - Department of Gastroenterology, Aichi Medical University, Aichi, Japan.
LA  - eng
PT  - Journal Article
DEP - 20221008
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Metals)
SB  - IM
MH  - Humans
MH  - *Cholestasis/etiology/surgery
MH  - Metals
MH  - Pilot Projects
MH  - Prospective Studies
MH  - *Stents/adverse effects
MH  - Treatment Outcome
EDAT- 2022/10/12 06:00
MHDA- 2023/01/25 06:00
CRDT- 2022/10/11 21:44
PHST- 2022/06/27 00:00 [received]
PHST- 2022/09/20 00:00 [revised]
PHST- 2022/09/26 00:00 [accepted]
PHST- 2022/10/12 06:00 [pubmed]
PHST- 2023/01/25 06:00 [medline]
PHST- 2022/10/11 21:44 [entrez]
AID - S0016-5107(22)02023-5 [pii]
AID - 10.1016/j.gie.2022.09.025 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2023 Feb;97(2):282-290.e1. doi: 10.1016/j.gie.2022.09.025. 
      Epub 2022 Oct 8.