Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction

Steel, Alan; Postgate, Aymer; Khorsandi, Shirin Elizabeth; Nicholls, Joanna P.; Jiao, Long R.; Vlavianos, Panagiotis; Habib, Nagy; Westaby, David

doi:10.1016/j.gie.2010.09.031

Cited by 288 publications

(233 citation statements)

References 31 publications

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“…In their study, they treated a total of 22 patients and demonstrated immediate and 30-day safety and 90-day biliary patency. They reported improved stricture after RFA treatment, with similar complication rates as in our study (1 asymptomatic biochemical pancreatitis, 2 cholecystitis) and one failure to decompress the bile duct, which eventually resulted in the patient's death [20].…”

Section: Discussionsupporting

confidence: 85%

“…Initial experience with RFA comes from the Hammersmith team [20] and is very encouraging. In their study, they treated a total of 22 patients and demonstrated immediate and 30-day safety and 90-day biliary patency.…”

Section: Discussionmentioning

confidence: 99%

“…This technique has been widely used to treat primary and secondary liver cancer [17]; however, the experience in malignant biliary obstruction is limited. There have been animal studies to assess the power 2 Journal of Oncology and duration of treatment [19], but there is only one study assessing this procedure in humans [20]. We aimed to assess the safety and efficacy of this novel palliative technique prospectively.…”

Section: Introductionmentioning

confidence: 99%

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387 Safety and Efficacy of Radiofrequency Ablation in the Management of Unresectable Bile Duct and Pancreatic Cancer: A Novel Palliation Technique

Figueroa-Barojas

Bakhru

Habib

et al. 2011

Gastrointestinal Endoscopy

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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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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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387 Safety and Efficacy of Radiofrequency Ablation in the Management of Unresectable Bile Duct and Pancreatic Cancer: A Novel Palliation Technique

Figueroa-Barojas

Bakhru

Habib

et al. 2011

Gastrointestinal Endoscopy

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“…77,79 Only recently has this technique been explored to manage advanced, unresectable pancreatic adenocarcinoma via endoscopic application, as many patients presenting with advanced pancreatic cancer are not surgical candidates. Steel et al 79 performed the pilot study of endobiliary RFA in patients with unresectable pancreatic cancer or cholangiocarcinoma causing malignant biliary obstruction. The RFA catheter (Habib EndoHPB; EMcision, London, UK) was applied directly to the biliary stricture under fluoroscopy guidance.…”

Section: Eus-guided Radiofrequency Ablationmentioning

confidence: 99%

“…This procedure was successful in 21 of 22 patients with adverse effects including cholecystitis requiring percutaneous drainage in two patients, sepsis, and mild pancreatitis. 79 RFA was subsequently applied under EUS in several animal studies, leading to the development of a novel monopolar RFA probe placed through a 19 or 22 gauge FNA needle (Habib EUS-RFA catheter; EMcision) (Fig. 5).…”

Section: Eus-guided Radiofrequency Ablationmentioning

confidence: 99%