New methodClinical endoscopyEndoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction
Section snippets
Patients
Patients with unresectable pancreatic or bile duct cancer were recruited for this pilot study. Exclusion criteria were uncorrected coagulopathy, cardiac pacemaker, failure to insert guidewire across a biliary stricture, Karnofsky score less than 40%,24 and inability to give informed consent. Prospective data were collected detailing ERCP complications, patient survival, and stent patency as long as 90 days after the procedure. Serial liver function tests (imaging where indicated) determined the
Results
Twenty-two patients were recruited for the study between January 2009 and April 2010. Patient data are shown in Table 1.
In 1 patient, irretrievable proximal migration of a plastic stent resulted in no attempt to deploy the RFA catheter; a SEMS procedure was undertaken.
SEMS placement was achieved in all cases of endobiliary deployment. There were no technical difficulties placing the RFA catheter across the biliary stricture. Six study subjects had evidence of hepatic hilar or intrahepatic
Discussion
This phase 1 study of endobiliary RFA treatment of malignant biliary obstruction demonstrates immediate and 30-day safety and 90-day biliary patency.
Potential complications identified in the preclinical pig model were extension of the RFA burn into local structures and difficulty reintroducing catheters into the bile duct after RFA treatment.22, 23 Furthermore, hemorrhage and abscess formation at the site of RFA are recognized complications of hepatic RFA.20, 21 These complications were not
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Multimodal treatment with endoscopic ablation and systemic therapy for cholangiocarcinoma
2024, Best Practice and Research: Clinical GastroenterologyHistory of the Interventional Pancreaticobiliary Endoscopy
2024, Gastrointestinal Endoscopy Clinics of North AmericaConsensus statements on endoscopic radiofrequency ablation for malignant biliary strictures
2024, Journal of Digestive DiseasesLong-term disease control by endobiliary radiofrequency ablation in localized extrahepatic cholangiocarcinoma: a first case report
2023, Clinical Journal of GastroenterologyExpert consensus on endoscopic radiofrequency ablation for malignant biliary strictures
2023, Chinese Journal of Digestive Endoscopy
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: Ms. Nicholls: stockholder and board member of EMcision Ltd UK; Dr. Habib: stockholder and board member of EMcision Ltd UK. The other authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Westaby at [email protected].