Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis
Unresectable malignant biliary strictures are generally managed by palliative stent placement for drainage of biliary tree. Recently, radiofrequency ablation (RFA) has been used to improve the patency of biliary stents in these patients. Several studies have evaluated the effectiveness of biliary stent placement with RFA on stent patency and patient survival with variable results. We performed this meta-analysis to evaluate the efficacy and safety of biliary stent placement with RFA compared with stent placement alone in patients with malignant biliary strictures.
We performed a comprehensive search of electronic databases for all the studies comparing RFA with biliary stent placement versus stent placement-only. Measured outcomes included patient survival, stent patency and procedure-related adverse events. Inverse variance method was used to pool data on stent patency into random-effects model. Cox-regression analysis was used to calculate Hazard ratio (HR) for survival analysis. We used the GRADE framework to interpret our findings.
Nine studies (including 2 abstracts) with a total of 505 patients were included in the meta-analysis. The pooled weighted mean difference in stent patency was 50.6 days (95% confidence interval (CI), 32.83-68.48) favoring patients receiving RFA. Pooled survival analysis of the reconstructed Kaplan-Meier data showed improved survival in patients treated with RFA (HR, 1.395; 95% CI, 1.145- 1.7; p < 0.001). However, RFA was associated with higher risk of post-procedural abdominal pain (31% vs 20%, p= 0.003). Our analysis did not show significant difference between the RFA and stent placement-only groups with regard to the risk of cholangitis, acute cholecystitis, pancreatitis, and hemobilia.
In the light of this limited data based on observational studies, RFA was found to be safe and was associated with improved stent patency in patients with malignant biliary strictures. In addition, RFA may be associated with improved survival in these patients.
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Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 October 2024.
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#4,306,379
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Outputs of similar age from Gastrointestinal Endoscopy
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