Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis

Sofi, Aijaz; Khan, Muhammad Ali; Das, Ananya; Sachdev, Mankanwal S.; Khuder, Sadik A.; Nawras, Ali; Lee, Wade

doi:10.1016/j.gie.2017.10.029

Cited by 126 publications

(126 citation statements)

References 15 publications

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“…Patients who received RFA had significantly longer stent patency (50 vs 37 days, P < 0.002) and survival (285 vs 248 days, P < 0.001). The only AE that was more frequently encountered in the RFA group was abdominal pain (31% vs 20% in the control group, P = 0.003) . This survival difference was observed even though the number of patients receiving systemic chemotherapy was significantly higher in the controls compared with those treated with RFA.…”

Section: Malignant Biliary Stricturesmentioning

confidence: 87%

“…The clinical value of biliary RFA has been recently confirmed in a systematic review and meta‐analysis including nine studies including 505 patients with malignant biliary strictures in whom biliary stenting with SEMS was done with or without prior RFA application through the endoscopic or the percutaneous routes . Patients who received RFA had significantly longer stent patency (50 vs 37 days, P < 0.002) and survival (285 vs 248 days, P < 0.001).…”

Section: Malignant Biliary Stricturesmentioning

confidence: 91%

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Endoscopic radiofrequency biliary ablation treatment: A comprehensive review

Larghi

Rimbaș

Tringali

et al. 2019

Digestive Endoscopy

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Radiofrequency ablation (RFA) functions by delivering thermal energy within tissue, the result of a high‐frequency alternating current released from an active electrode, leading to coagulative necrosis and cellular death. Recently, a biliary catheter working on a guidewire has been developed and a number of studies have so far been carried out. The present article provides a comprehensive review of the literature on the results of the use of RFA for the clinical management of patients with unresectable malignant biliary strictures, benign biliary strictures, and residual adenomatous tissue in the bile duct after endoscopic papillectomy. Available data show that biliary RFA treatment is a promising adjuvant therapy in patients with unresectable malignant biliary obstruction. The procedure is safe, well tolerated and improves stent patency and survival, even though more studies are warranted. In patients with residual endobiliary adenomatous tissue after endoscopic papillectomy, a significant rate of neoplasia eradication after a single RFA session has been reported, thus favoring this treatment over surgical intervention. In these patients, as well as in those with benign biliary strictures, dedicated probes with a short electrode able to focus the RF current on the short stenosis are needed to expand RFA treatment for these indications.

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Section: Malignant Biliary Stricturesmentioning

confidence: 87%

Section: Malignant Biliary Stricturesmentioning

confidence: 91%

Endoscopic radiofrequency biliary ablation treatment: A comprehensive review

Larghi

Rimbaș

Tringali

et al. 2019

Digestive Endoscopy

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“…Endoscopic bile duct RFA therapy with a dedicated catheter has emerged as an adjunctive treatment of MBS arising from biliopancreatic malignancies . RFA therapy has already been used to treat patients with hepatocellular carcinoma or Barrett's esophagus with dysplasia.…”

Section: Discussionmentioning

confidence: 99%

“…However, definitive data from well‐controlled, prospective studies on the efficacy of endobiliary RFA are lacking. Sofi et al . published a systematic review and meta‐analysis of RFA combined with biliary stenting versus stenting alone for MBS.…”

Section: Discussionmentioning

confidence: 99%

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The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study

Lee

Jeong

Choi

et al. 2019

J of Gastro and Hepatol

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Background and Aims Catheter‐based endobiliary radiofrequency ablation (RFA) is an endoscopic local treatment for patients with malignant biliary stricture (MBS). However, excessive heating of the bile duct by the current RFA system can induce serious complications. Recently, a new RFA system with automatic temperature control was developed. In the present study, we examined the safety of the new RFA system in patients undergoing endobiliary RFA for extrahepatic MBS. Methods This prospective, multicenter study enrolled patients with unresectable or inoperable extrahepatic (> 2 cm from the hilum) MBS. Endobiliary RFA was performed using a newly developed RFA catheter (ELRA™, STARmed, Goyang, Korea) at a setting of 7 or 10 W for 120 s and with a target temperature of 80°C. A self‐expandable metallic stent was inserted after endobiliary RFA. The rate of procedure‐related adverse events was assessed. Results The 30 patients were enrolled in this study. Cholangiocarcinoma was diagnosed in 19 patients, pancreatic cancer was found in 9, and gallbladder cancers were recorded in 2. The mean stricture length was 22.1 ± 6.6 mm. Post‐procedural adverse events occurred in three patients (10.0%; 2 mild pancreatitis and 1 cholangitis) without hemobilia and bile duct perforation. The pancreatitis and cholangitis resolved with conservative treatment. The cumulative duration of stent patency and survival were 236 and 383 days, respectively. Conclusions Automatic temperature‐controlled endobiliary RFA using a newly developed catheter was safely applied in patents with extrahepatic MBS. Further prospective studies are needed to confirm the efficacy of endobiliary RFA for MBS.

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Cholangioscopy and Pancreatoscopy

Sethi¹

2022

Successful Training in Gastrointestinal Endoscopy

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Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis

Cited by 126 publications

References 15 publications

Endoscopic radiofrequency biliary ablation treatment: A comprehensive review

Endoscopic radiofrequency biliary ablation treatment: A comprehensive review

The safety of newly developed automatic temperature‐controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study

Cholangioscopy and Pancreatoscopy

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