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ENDOLUMINAL RADIOFREQUENCY ABLATION WITH STENTING VS STENTING ONLY IN PATIENTS WITH MALIGNANT BILIARY OBSTRUCTION: A META-ANALYSIS OF RANDOMISED TRIALS.
- Source :
-
Endoscopy [Endoscopy] 2024 Aug 02. Date of Electronic Publication: 2024 Aug 02. - Publication Year :
- 2024
- Publisher :
- Ahead of Print
-
Abstract
- Introduction: Endoluminal radiofrequency ablation (RFA) is a palliative treatment for patients suffering from malignant biliary obstruction. We aimed to conduct a meta-analysis to evaluate the impact of RFA on stent patency, patient survival, and adverse events.<br />Methods: Major databases were searched through November 2023 for patients who underwent stenting with or without RFA for extra-hepatic malignant biliary obstruction. A random effects model was employed for analysis and results conveyed using relative risk ratio with 95% confidence interval.<br />Results: Nine RCTs involving 750 subjects (n=374 RFA plus stent vs. n=376 stent only) with malignant biliary obstruction were included. Meta-analysis revealed similar risks of stent patency at 3 months (RR = 1.01; 95% CI [0.92 - 1.11], I2=4% for RFA plus stenting vs. stent only). Meta-analysis showed improved survival at 6 months (RR = 0.84; 95% CI [0.73 - 0.96], I2=21%, P=0.01 for RFA plus stenting vs. stent only). Subgroup analysis comparing plastic vs uncovered metal stents showed that stent patency was unaffected at 3 months (RR = 1.06; 95% CI [0.91 - 1.23]; I2=17%). Subgroup analysis showed that patients with cholangiocarcinoma experienced an overall survival benefit with RFA plus stenting vs. stent only (P<0.001), however, stent patency remained unaffected (P=0.08). An increased incidence of cholecystitis was noted with RFA plus stent vs. stent only (5.1%; 95% CI [3.1% - 7.8%] vs 0.3%; 95% CI [0.01% - 1.5%], respectively).<br />Conclusion: Combining endoluminal RFA and stenting may improve overall survival in patients with malignant biliary obstruction. RFA did not impact stent patency significantly.<br />Competing Interests: Conflicts of Interest: Mouen Khashab is a consultant for Boston Scientific, Medtronic, Olympus, Pentax, GI Supply, and Apollo. He receives research support from Boston Scientific and royalties from Elsevier and UpToDate; Benedetto Mangiavillano received a fee for a speech from Taewoong; Francesco Crinò received a grant from Steris Endoscopy; the remaining authors declare that there is no conflict of interest<br /> (Thieme. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1438-8812
- Database :
- MEDLINE
- Journal :
- Endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 39094769
- Full Text :
- https://doi.org/10.1055/a-2378-9533