腔内射频消融（RFA）是一种针对恶性胆道梗阻患者的姑息治疗。我们旨在进行一项荟萃分析，以评估 RFA 对支架通畅、患者生存和不良事件的影响。检索了截至 2023 年 11 月因肝外恶性胆道梗阻而接受或未接受 RFA 支架置入术的患者的主要数据库。采用随机效应模型进行分析，并使用具有 95% 置信区间的相对风险比传达结果。 纳入了 9 项随机对照试验，涉及 750 名患有恶性胆道梗阻的受试者（n=374 例 RFA 加支架 vs. n=376 只支架）。荟萃分析显示，3 个月时支架通畅的风险相似（RR = 1.01；95% CI [0.92 - 1.11]，RFA 加支架置入与仅置入支架的 I2=4%）。荟萃分析显示，RFA 加支架置入术与仅支架置入术相比，6 个月时的生存率有所提高（RR = 0.84；95% CI [0.73 - 0.96]，I2=21%，P=0.01）。比较塑料支架与未覆盖金属支架的亚组分析表明，支架通畅性在 3 个月时未受影响（RR = 1.06；95% CI [0.91 - 1.23]；I2=17%）。亚组分析显示，与仅使用支架相比，接受 RFA 加支架置入术的胆管癌患者的总体生存期有所改善 (P<0.001)，但支架通畅率不受影响 (P=0.08)。 RFA 加支架与仅支架相比，胆囊炎的发生率增加（分别为 5.1%；95% CI [3.1% - 7.8%] vs 0.3%；95% CI [0.01% - 1.5%]）。支架置入术可以改善恶性胆道梗阻患者的总生存率。 RFA 不会显着影响支架通畅。Thieme。版权所有。

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.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.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).Combining endoluminal RFA and stenting may improve overall survival in patients with malignant biliary obstruction. RFA did not impact stent patency significantly.Thieme. All rights reserved.