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. 2013:2013:910897.
doi: 10.1155/2013/910897. Epub 2013 Apr 8.

Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer: a novel palliation technique

Paola Figueroa-Barojas  1 , Mihir R Bakhru, Nagy A Habib, Kristi Ellen, Jennifer Millman, Armeen Jamal-Kabani, Monica Gaidhane, Michel Kahaleh
Affiliations

Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer: a novel palliation technique

Paola Figueroa-Barojas et al. J Oncol. 2013.

Abstract

Objectives. Radiofrequency ablation (RFA) has replaced photodynamic therapy for premalignant and malignant lesions of the esophagus. However, there is limited experience in the bile duct. The objective of this pilot study was to assess the safety and efficacy of RFA in malignant biliary strictures.

Methods: Twenty patients with unresectable malignant biliary strictures underwent RFA with stenting between June 2010 and July 2012. Diameters of the stricture before and after RFA, immediate and 30 day complications and stent patency were recorded prospectively. Results. A total of 25 strictures were treated. Mean stricture length treated was 15.2 mm (SD = 8.7 mm, Range = 3.5-33 mm). Mean stricture diameter before RFA was 1.7 mm (SD = 0.9 mm, Range = 0.5-3.4 mm) while the mean diameter after RFA was 5.2 mm (SD = 2 mm, Range = 2.6-9 mm). There was a significant increase of 3.5 mm (t = 10.8, DF = 24, P value = <.0001) in the bile duct diameter post RFA. Five patients presented with pain after the procedure, but only one developed mild post-ERCP pancreatitis and cholecystitis.

Conclusions: Radiofrequency ablation can be a safe palliation option for unresectable malignant biliary strictures. A multicenter randomized controlled trial is required to confirm the long term benefits of RFA and stenting compared to stenting alone.

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Figures

Figure 1
Figure 1
Fluoroscopic images of bile duct cancer at the confluence with a Bismuth III lesion.
Figure 2
Figure 2
EndoHPB Probe for radio frequency ablation.
Figure 3
Figure 3
Application of radiofrequency at the level of the left hepatic duct.
Figure 4
Figure 4
Application of radiofrequency ablation at the level of the right hepatic duct.
Figure 5
Figure 5
Placement of biliary stent posts radiofrequency application.
See this image and copyright information in PMC

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