Efficacy and safety of endobiliary radiofrequency ablation for the eradication of residual neoplasia after endoscopic papillectomy: a multicenter prospective study

Endoscopic radiofrequency biliary ablation treatment: A comprehensive review

“…Rate of residual neoplasia at 6 and 12 months was 15% and 30%, respectively, and occurred more commonly in patients with high‐grade dysplasia as indication for the procedure. Interestingly, if there was no suspicion of invasive carcinoma (occurring in two cases in this study), the patients could be treated with a second biliary RFA session . Despite the fact that eight of the patients (40%) had at least one AE during the 12‐month follow‐up period, none was severe.…”

“…Interestingly, if there was no suspicion of invasive carcinoma (occurring in two cases in this study), the patients could be treated with a second biliary RFA session. 48 Despite the fact that eight of the patients (40%) had at least one AE during the 12-month follow-up period, none was severe. Thus, the rate of 70% neoplasia eradication after one single RFA session favors this treatment over surgical intervention, which, in these patients, would involve at least limited duodenal resection with papillectomy and re-implantation of the bile and pancreatic ducts.…”

“…Mean length of endobiliary ingrowth was 11.2 ± 4.5 mm. The procedure was followed by SEMS or plastic stent placement, and in 25% of the patients, pancreatic stent was also placed to prevent pancreatitis . No immediate complications occurred, whereas three patients developed mild acute post‐procedural pancreatitis (none of them received prophylactic pancreatic stents), and one on antiplatelet drugs developed self‐limited bleeding.…”

“…After a few case reports and a small retrospective series ( Table 2) [44][45][46][47] indicating that endoscopic targeted RFA of neoplastic tissue extending from the ampullary orifice to the CBD or the pancreatic duct can successfully treat this condition with an acceptable safety profile, a first prospective study on a meaningful number of patients has been published. 48 Twenty patients with residual endobiliary adenomatous tissue occurring an average of 1.4 years after endoscopic papillectomy (15 with low-grade dysplasia and five with high-grade dysplasia) were treated. 48 RFA was applied for 30 s at a power of 10 W over the distal CBD.…”

“…48 Twenty patients with residual endobiliary adenomatous tissue occurring an average of 1.4 years after endoscopic papillectomy (15 with low-grade dysplasia and five with high-grade dysplasia) were treated. 48 RFA was applied for 30 s at a power of 10 W over the distal CBD. A representative case is shown in Figure 6.…”