Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with malignant obstructive jaundice. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling malignant obstructive jaundice to be treated noninvasively.
The primary options for treatment of malignant obstructive jaundice include endoscopic retrograde cholangio-pancreatography (ERCP) and endoscopic ultrasound (EUS).
For certain patients, focused ultrasound could provide a noninvasive alternative to the existing procedures with improved outcomes combined with lower risk of complications.
- Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
In the report on a recent clinical trial, patients were either treated with focused ultrasound or not and then had biliary stents. Those receiving focused ultrasound had a longer stent patency time (367 vs. 257) and also a longer survival time (238 vs. 152). The authors conclude that focused ultrasound is a safe and easy way to improve outcomes in these patients.
At the present time, there are no clinical trials recruiting patients for treatment of malignant obstructive jaundice.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for malignant obstructive jaundice is not yet approved by regulatory bodies or covered by medical insurance companies.
Niu S1, Cheng L, Qiao Y, Fu YF, Cao C. Combined Stent Insertion and High-intensity Focused Ultrasound Ablation for Patients With Malignant Obstructive Jaundice. Surg Laparosc Endosc Percutan Tech. 2016 Oct 25.
Wang K, Zhu H, Meng Z, Chen Z, Lin J, Shen Y, Gao H. Safety evaluation of high-intensity focused ultrasound in patients with pancreatic cancer. Onkologie. 2013;36(3):88-92. doi: 10.1159/000348530.
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