Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

Pai, Madhava; Válek, Vlastimil; Andrasina, Tomas; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

doi:10.1007/s00270-013-0688-x

Cited by 42 publications

(35 citation statements)

References 27 publications

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“…Based on this study, the metal stent would prevent the bipolar RFA catheter from contacting and ablating the bile duct tumor when performing repeat ERFA [23]. Furthermore, direct contact with the bipolar RFA catheter with the uncovered metal stent could produce a short-circuit, making it impossible for a repeat endobiliary RFA.…”

Section: Discussionmentioning

confidence: 98%

Metal Stenting with or without Endobiliary Radiofrequency Ablation for Unresectable Extrahepatic Cholangiocarcinoma

Liang¹,

Peng²,

Cao³

et al. 2015

JCT

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Background: Retrospective comparison of stent patency and survival of patients with unresectable extrahepatic cholangiocarcinoma (CCA) treated by placement of self-expanding metal stents (SEMS) with or without endobiliary radiofrequency ablation (ERFA). Methods: Between January 2010 and September 2014, 76 patients with biliary obstruction caused by unresectable extrahepatic CCA (27 patients with Bismuth type I hilar CCA and 49 patients with distal CCA) were recruited into this study. Patients either received ERFA with SEMS (n = 34) or SEMS only (n = 42). Stent patency and survival of both groups were compared and predictors for overall survival were analyzed. Results: Demographic data were not different between the two groups. Complication rates of both groups were similar. Thirty-day stent patency was obtained in all patients and the median stent patency in the ERFA + SEMS group (9.5 months, 4.5 -14.0 months) was significantly longer than that in the SEMS group (8.4 months, 4.9 -11 months) (P = 0.024). The overall survival curve in the ERFA + SEMS group was significantly better than that of the SEMS group (P = 0.036). Multivariate Cox proportional hazards regression analyses showed that ERFA, tumor AJCC stage, extrahepatic CCA type, serum albumin and adjuvant chemotherapy were significant prognostic factors for overall patient survival. Conclusions: ERFA is effective for unresectable extrahepatic CCA and may improve metal stent patency and patient survival for unresectable extrahepatic CCA with biliary obstruction. Prospective randomized trials will be needed to confirm these findings.

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Section: Discussionmentioning

confidence: 98%

Metal Stenting with or without Endobiliary Radiofrequency Ablation for Unresectable Extrahepatic Cholangiocarcinoma

Liang¹,

Peng²,

Cao³

et al. 2015

JCT

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“…These patients had a relatively long survival and 1 patient was still alive at the end of the follow-up period. Due to the easy and minimally invasive procedure, intraductal RFA was used to clear occluded metal stents [21], which was also confirmed by our previous study [15]. 1 previous report asserted that ablation treatment should be performed cautiously because of excessive charring leading to perforation [10].…”

Section: Discussionmentioning

confidence: 59%

“…For patients with long segmental obstruction of the bile duct, RFA was performed section by section. For a few patients who had high-level obstruction and tumors involving the bilateral bile ducts, RFA of the bilateral intrahepatic bile ducts was required [21]. In our study, 3 patients with stent blockage underwent repeat ablation, and 1 patient received 3 sessions of ablation.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction Caused by Recurrence and Metastasis after Primary Tumor Resection

Cui

Fan²,

Lu³

et al. 2018

Oncol Res Treat

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Background: To assess the feasibility and safety of percutaneous intraductal radiofrequency ablation (RFA) for malignant biliary obstruction caused by recurrence and metastasis after primary tumor resection. Patients and Methods: Percutaneous intraductal biliary RFA and stent placement were performed in 19 consecutive patients with 24 RFA procedures. Procedure-related complications, stent patency, and survival after treatment were investigated. Results: During 30 days after each RFA procedure there was no 30-day mortality, hemorrhage, bile duct perforation, or pancreatitis. Of the 19 patients, 2 are still alive and 17 are dead with a median survival time of 6.0 (range 1.2-16) months and a median stent patency of 3.2 (range 1.2-14) months. 10 patients had their stent patent at the time of last follow-up or death. 3 patients with stent blockage at 50, 182, and 200 days post procedure underwent repeat ablation. 1 patient with stent blockage underwent 2 repeat RFA procedures at 192 days after the first ablation and at 86 days after the repeat ablation. Conclusion: Percutaneous intraductal RFA is a technically safe and feasible therapeutic option for palliative treatment of these selected patients.

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“…Radiofrequency ablation (RFA), or microwave ablation, has been successfully used in the treatment of solid tumors in the liver, lung, breast, kidney and many other tumor types. This technique has also been demonstrated to be safe and promising when performed percutaneously or endoscopically for locally advanced PDAC [44][45][46][47]. Increasingly, there is evidence from series around the world that open intra-operative RFA is a safe and feasible way to provide tumor cytoreduction and partial necrosis in locally advanced pancreatic tumors, leading to good survival rates and an improvement in quality of life [46,48].…”

Section: Expert Commentary and Five-year Viewmentioning

confidence: 99%

Surgical techniques for improving outcomes in pancreatic ductal adenocarcinoma

Gall

Thompson

Dinneen

et al. 2014

Expert Review of Gastroenterology & Hepatology

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Pancreatic ductal adenocarcinoma is a devastating disease with extremely poor survival despite patients undergoing potentially curative resections and improvements in chemotherapeutic agents. Surgery for operable cancer in the head of the pancreas typically involves an open pancreaticoduodenectomy with a post-operative median survival of 21 months. Newer surgical techniques, however, aim to improve patient outcomes in terms of both their hospital experience and better oncological results. This article focuses on the evidence to date for some of these surgical techniques including laparoscopic and robotic surgery, the no-touch technique, venous and arterial resection, intra-operative radiofrequency ablation and intra-operative irreversible electroporation. With the increased use of these techniques we hope to see better quality of life and survival for these patients.

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Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

Abstract: In this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

Cited by 42 publications

References 27 publications

Metal Stenting with or without Endobiliary Radiofrequency Ablation for Unresectable Extrahepatic Cholangiocarcinoma

Metal Stenting with or without Endobiliary Radiofrequency Ablation for Unresectable Extrahepatic Cholangiocarcinoma

Percutaneous Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction Caused by Recurrence and Metastasis after Primary Tumor Resection

Surgical techniques for improving outcomes in pancreatic ductal adenocarcinoma

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