Endoscopic radiofrequency ablation of a cholangiocarcinoma with targeted intraductal cholangioscopic access

Romero, Lidia Martí; Escapa, Vanesa Martínez; Miralles, Inmaculada Castelló; Gutierrez, German Lacal; Párraga, C. Ivars; Perez, Gloria Alemany; Ribelles, Jose Manuel Querol

doi:10.1055/a-1174-5399

Cited by 1 publication

(2 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, it has been proposed to perform two consecutive 60 seconds ablations with an interval time of 60 seconds which is useful for checking the position of the electrodes by means of fluoroscopy and detecting the possible onset of adverse events, such as bleeding ( 53 ). The best way to correctly place the electrodes of the ERFA catheter inside the biliary stricture is to position the probe after direct visualization and evaluation of the stenosis using the peroral digital cholangioscope ( 57 – 59 ). Subsequently, another cholangioscopy evaluates the efficacy of the ablation and rules out possible immediate complications, such as bleeding and perforation ( 60 ).…”

Section: Endobiliary Radiofrequency Ablationmentioning

confidence: 99%

“…ERFA should be repeated when IDUS detects a significant increase in tumor thickness and a reduction in the bile duct diameter at the site of the previously treated stricture (18). Another technique used to monitor the results of ERFA is cholangioscopy which can also guide the correct placement of the ERFA catheter inside the targeted biliary stricure (58)(59)(60). Ideally, plastic stents are indicated when multiple sessions of ERFA are scheduled in patients with a locally advanced CCA without metastases and in good functional status (24).…”

Section: Erfa and Stent Patencymentioning

confidence: 99%

See 1 more Smart Citation

Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review

et al. 2023

View full text Add to dashboard Cite

Cholangiocarcinoma (CCA) is a rare cancer originating from the biliary epithelium and accounts for about 3% of all gastrointestinal malignancies. Unfortunately, the majority of patients are not eligible for surgical resection at the time of diagnosis, because of the locally advanced stage or metastatic disease. The overall survival time of unresectable CCA is generally less than 1 year, despite current chemotherapy regimens. Biliary drainage is often required as a palliative treatment for patients with unresectable CCA. Recurrent jaundice and cholangitis tend to occur because of reobstruction of the biliary stents. This not only jeopardizes the efficacy of chemotherapy, but also causes significant morbidity and mortality. Effective control of tumor growth is crucial for prolonging stent patency and consequently patient survival. Recently, endobiliary radiofrequency ablation (ERFA) has been experimented as a treatment modality to reduce tumor mass, and delay tumor growth, extending stent patency. Ablation is accomplished by means of high-frequency alternating current which is released from the active electrode of an endobiliary probe placed in a biliary stricture. It has been shown that tumor necrosis releases intracellular particles which are highly immunogenic and activate antigen-presenting cells, enhancing local immunity directed against the tumor. This immunogenic response could potentially enhance tumor suppression and be responsible for improved survival of patients with unresectable CCA who undergo ERFA. Several studies have demonstrated that ERFA is associated with an increased median survival of approximately 6 months in patients with unresectable CCA. Furthermore, recent data support the hypothesis that ERFA could ameliorate the efficacy of chemotherapy administered to patients with unresectable CCA, without increasing the risk of complications. This narrative review discusses the results of the studies published in recent years and focuses on the impact that ERFA could have on overall survival of patients with unresectable cholangiocarcinoma.

show abstract