To explore the efficacy of radiofrequency ablation combined with biliary endoscopy in treating restenosis after metal stent implantation for malignant biliary obstruction.

A total of 100 patients with restenosis after metal stent implantation for malignant biliary obstruction admitted to the Department of Endoscopic Surgery, Cangzhou Central Hospital of Hebei Province from January 2021 to December 2022 were enrolled as research subjects.Patients were divided into combination group and control group according to treatment regimens, with 50 cases in each group.The combination group received radiofrequency ablation combined with cholangioscopy-guided debridement and stent recanalization, while the control group underwent conventional balloon dilation and stent recanalization.Observation indicators: Primary outcome: clinical success rate; Secondary outcomes: technical success rate; stent patency rate; incidence of adverse events; perioperative indicators.This is a retrospective observational non-randomized study.Baseline balance was achieved only at the statistical level, and selection bias may still exist.

Compared with the control group, the operation time of the combined group was longer and the intraoperative blood loss was lower, and the difference was statistically significant (P<0.05); there were no statistically significant differences in gender, age, body mass index, jaundice duration, Child-Pugh classification, obstruction site, surgical success rate, hospital stay, tumor type, stent diameter, and stent length between the two groups (P>0.05); Compared with the control group, the biliary tract patency rate at 3 months (94%) and 6 months (86%) after surgery in the combined group increased, and the difference was statistically significant (P<0.05), while the patency rate at 1 month after surgery was not statistically significant between the two groups (P>0.05); The complication rate of the control group was 16%, and that of the combined group was 4%, and the difference was statistically significant (P<0.05); The total effective rate of treatment in the control group was 76%, and that in the combined group was 92%, and the difference was statistically significant (P<0.05).

This study only reflects the true clinical effect differences between the two complete clinical intervention schemes.Due to the confounding effect of the dual intervention of biliary endoscopy and radiofrequency ablation, it cannot be determined that the therapeutic advantage is solely caused by radiofrequency ablation alone.The combined radiofrequency ablation and biliary endoscopy direct vision scheme performs better in increasing the overall clinical effectiveness rate and prolonging the biliary patency time, and does not increase the risk of complications, and thus has clinical reference value.