E0009 - Radiofrequency Ablation With Stent versus Stent-Only for Biliary Tree Drainage in Patients With Malignant Biliary Strictures: A Systemic Review and Meta-Analysis
Umar Hayat, MBBS1, Cyrus Munguti, MD1, Muhammad Kamal, MD2, Muhammad Haseeb, MD, MSc3 1University of Kansas, Wichita, KS; 2Essen Healthcare System, New York, NY; 3Beth Israel Deaconess Medical Center, Boston, MA
Introduction: Cholangiocarcinoma and adenocarcinoma are major causes of malignant biliary obstruction. Palliative stent placement is the general management strategy for biliary drainage in unresectable malignant biliary strictures. Studies have shown that Endoscopic Radiofrequency Ablation (RFA) can improve the overall stent patency and survival time among patients with malignant biliary tumors. Therefore, our study aimed to assess the efficacy and safety of biliary stenting with RFA compared with stents alone to treat malignant biliary strictures.
Methods: A systemic search of major databases through April 2022 was done. All original studies comparing radiofrequency ablation along with stenting versus stenting alone for treating malignant biliary tumors were included. The primary outcomes of interest were the difference in the mean stent patency and overall survival days between the two groups. Secondary outcome of interest was adverse events between the two groups. The mean difference in the stent patency and overall survival days was pooled by using a random-effect model. We calculated the odds ratio to compare the adverse events between the two groups. All analyses were done by using STATA 17 software.
Results: A total of 13 studies with 1339 patients were identified, reporting follow-up data of the original research. The pooled weighted mean difference in stent patency was 43.50 days (95% confidence interval [CI], 25.60-61.41), favoring the RFA plus stenting. Moreover, the pooled weighted mean difference in overall survival was 90.53 days (95% confidence interval [CI], 49.00-132.07), showing improved survival in RFA group. Our analysis showed no statistically significant difference OR 1.07 (95% confidence interval [CI], 0.80-1.34) between the RFA and stent-only group regarding adverse events such as post-procedural abdominal pain, and cholangitis, pancreatitis, and acute cholecystitis.
Discussion: Our systematic review shows that RFA along with stent is safe and is associated with improved stent patency and overall patient survival in malignant biliary strictures. More robust prospective studies should assess this association further.
Figure: Forest Plots of the Mean Difference between RFA with stent and stent only (Stent Patency and Overall Survival)
Disclosures:
Umar Hayat indicated no relevant financial relationships.
Cyrus Munguti indicated no relevant financial relationships.
Muhammad Kamal indicated no relevant financial relationships.
Muhammad Haseeb indicated no relevant financial relationships.
Umar Hayat, MBBS1, Cyrus Munguti, MD1, Muhammad Kamal, MD2, Muhammad Haseeb, MD, MSc3. E0009 - Radiofrequency Ablation With Stent versus Stent-Only for Biliary Tree Drainage in Patients With Malignant Biliary Strictures: A Systemic Review and Meta-Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.
