Endobiliary radiofrequency ablation for malignant biliary obstruction

• Published in: Hepatobiliary & pancreatic diseases international Vol. 12; no. 4; pp. 423 - 427
• Main Authors: Alis, Halil, Sengoz, Cetin, Gonenc, Murat, Kalayci, Mustafa Uygar, Kocatas, Ali
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01-08-2013
• Subjects: ablation; Aged; Bile Duct Neoplasms - complications; Bile Ducts, Extrahepatic; Catheter Ablation - adverse effects; cholangicarcinoma; Cholangiocarcinoma - complications; Cholangiopancreatography, Endoscopic Retrograde - adverse effects; Cholestasis - etiology; Cholestasis - surgery; endobiliary; endobiliary stenting; Endocrinology & Metabolism; Female; Gastroenterology and Hepatology; Humans; jaundice; Klatskin; Klatskin tumor; Male; Middle Aged; obstructive; obstructive jaundice; Palliative Care; Pancreatitis - etiology; radiofrequency; radiofrequency ablation; Retrospective Studies; stenting; Stents; tumor; cholangicarcinoma; endobiliary stenting; radiofrequency ablation; obstructive jaundice; Klatskin tumor
• ISSN: 1499-3872
• DOI: 10.1016/S1499-3872(13)60066-1

BACKGROUND: The cornerstone of palliative treatment for inoperable extrahepatic cholangiocarcinoma is the relief of malignant biliary obstruction. The most commonly applied method is endoscopic stenting. However, the procedure can be complicated with stent obstruction. In this respect, endobiliary radiofrequency ablation may serve as an adjunctive tool for prolonging the stent patency. METHODS: Patients who underwent endoscopic retrograde cholangiopancreatography for differential diagnosis and/ or palliative treatment after the diagnosis of inoperable extrahepatic cholangiocarcinoma between March 2011 and January 2012 were analyzed. Those in whom endobiliary radiofrequency ablation and endoscopic stenting was successfully performed were included in the study. Technical details of the procedure, duration of stent patency, length of hospital stay, short-term morbidity and mortality rate were documented. RESULTS: Seventeen patients were analyzed, and 10 patients were included in the study. The morbidity and mortality rate within the first 30 days after the procedure was 20% and 0%, respectively. In 2 patients, mild pancreatitis occurred because of the endobiliary procedure. In 1 patient, endobiliary decompression could not be achieved, and therefore, percutaneous transhepatic biliary drainage was carried out. The median duration of stent patency in 9 patients with successful biliary decompression was 9 months (range 6-15). CONCLUSION: Endobiliary radiofrequency ablation seems to be safe and feasible as a palliative measure and may prolong the stent patency and overall survival in patients with malignant biliary obstruction due to inoperable extrahepatic cholangio-carcinoma.