Radiofrequency and malignant biliary strictures: An update

Abstract

Malignant biliary strictures are usually linked to different types of tumors, mainly cholangiocarcinoma, pancreatic and hepatocellular carcinomas. Palliative measures are usually adopted in patients with nonresectable or borderline resectable biliary disease. Stent placement is a well-known and established treatment in patients with unresectable malignancy. Intraductal radiofrequency ablation (RFA) represents a procedure that involves the use of a biliary catheter device, via an endoscopic approach. Indications for biliary RFA described in literature are: Palliative treatment of malignant biliary strictures, avoiding stent occlusion, ablating ingrowth of blocked metal stents, prolonging stent patency, ablating residual adenomatous tissue after endoscopic ampullectomy. In this mini-review we addressed focus on technical success defined as deployment of the RF catheter, virtually succeeded in all patients included in the studies. About efficacy, three main outcome measures have been contemplated: Biliary decompression and stent patency, survival. Existing studies suggest a beneficial effect on survival and stent patency with RFA, but current impression is limited because most of studies have been performed using a retrospective design, on diminutive and dissimilar cohorts of patients.

Design and Characterization of a Minimally Invasive Bipolar Electrode for Electroporation

“…Bipolar electrodes were also realized for radiofrequency ablation (RFA) via the endoscopic approach to treat inoperable malignant tumor in biliary structures, avoiding stents occlusion, ablating ingrowth of blocked metal stents, prolonging stents patency and ablating residual adenomatous tissue after endoscopic ampullectomy [40][41][42][43].…”

Percutaneous endobiliary radiofrequency ablation for tumor ingrowth causing metal stent obstruction

“…Thus, combination with local therapies has been attempted to improve patients’ survival and quality of life. Radiofrequency ablation (RFA) is a local ablative therapy using heat that leads to coagulative necrosis and local tumor destruction 2,3 . We describe a case of percutaneous endobiliary RFA for recurring bile duct cancer after surgery causing metal stent obstruction.…”

Nonsurgical Approaches to Treat Biliary Tract and Liver Tumors

“…Ablation is performed at all sites of stricture for two minutes. Finally, a stent is placed across the treated area and the scope is withdrawn (31)(32)(33). Use of RFA delivered via the percutaneous approach for distal cholangiocarcinoma and PHC has also been described (34)(35)(36)(37).…”