Stent insertion combined with high-intensity focused ultrasound ablation for malignant obstructive jaundice caused by pancreatic carcinoma / 局解手术学杂志

ABSTRACT

Objective To investigate the safety and efficacy of stent insertion combined with high-intensity focused ultrasound(HIFU) ablation for malignant obstructive jaundice caused by pancreatic carcinoma.Methods From January 2013 to February 2017,a total of 80 patients with malignant obstructive jaundice caused by pancreatic carcinoma underwent biliary stent insertion in our center,who were divided into combined treatment(stent insertion with HIFU ablation) group(n=38) and solitary stent insertion group(n=42).The stent patency time and survival time were compared between the two groups.Results Relief of jaundice were archived in all patients in both groups.Cholangitis was observed in 7 cases in both two groups.Reobstruction of stent was observed in 15 patients in both two groups.The median stent patency time was 179 days in combined treatment group and 119 days in solitary stent insertion group(P<0.01);the median survival time was 209 days in combined treatment group and 145 days in solitary stent insertion group,the differences were significant(P<0.01).Based on the univariate and multivariate Cox regression analyses,the predictors of prolonging survival included subsequent HIFU ablation after stent insertion and earlier tumor stage(P<0.05).Conclusion Combined biliary stent insertion and HIFU ablation is a safe and effective method for malignant obstructive jaundice caused by pancreatic carcinoma,and seems to extend stent patency time and survival when compared with biliary stent only.