Intraductal Radiofrequency Ablation as a Palliative Treatment for Advanced Malignant Hilar Biliary Obstruction
Open Access
- 1 June 2022
- journal article
- Published by Korean Association of Internal Medicine in Korean Journal of Medicine
- Vol. 97 (3), 164-170
- https://doi.org/10.3904/kjm.2022.97.3.164
Abstract
Malignant hilar biliary obstruction (MHBO) frequently accompanies cholestasis and cholangitis, and requires biliary stent placement. To prevent stent occlusion and prolong survival, local ablation therapy can be considered adjunctive to stent placement. Intraductal radiofrequency ablation (ID-RFA) is a recently developed local therapy for malignant biliary obstruction that can be easily performed employing endoscopic retrograde cholangiography. The use of ID-RFA to treat MHBO (as distinct from distal biliary obstruction) was suggested to be associated with severe adverse events. However, recent comparative studies have shown that ID-RFA is feasible and safe, and acceptably efficacious, in patients with advanced MHBO; newer temperature-controlled ID-RFA devices may enhance safety further. Regularly repeated ID-RFA with stent exchange affords better survival than stenting alone. However, the optimal ID-RFA strategy for MHBO remains inconclusive given the lack of data. Further large-scale clinical trials are needed.Keywords
This publication has 26 references indexed in Scilit:
- The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter studyJournal of Gastroenterology and Hepatology, 2019
- Biliary tract cancer incidence and trends in the United States by demographic group, 1999‐2013Cancer, 2019
- Long-term results of temperature-controlled endobiliary radiofrequency ablation in a normal swine modelGastrointestinal Endoscopy, 2018
- Efficacy and safety of endoscopic radiofrequency ablation for unresectable extrahepatic cholangiocarcinoma: a randomized trialEndoscopy, 2018
- A new intraductal radiofrequency ablation device for inoperable biliopancreatic tumors complicated by obstructive jaundice: the IGNITE-1 studyEndoscopy, 2017
- Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinomaSurgical Endoscopy, 2015
- ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinomaGastrointestinal Endoscopy, 2014
- Intraductal endoscopic radiofrequency ablation for the treatment of hilar non-resectable malignant bile duct obstructionWorld Journal of Gastrointestinal Endoscopy, 2014
- Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applicationsSurgical Endoscopy, 2013
- Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstructionEuropean Journal of Gastroenterology & Hepatology, 2007