Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma

Abstract

Endoscopic radiofrequency treatment of inoperable CCA appears without major risks and is feasible. No major adverse events or biliary fistula were identified.

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

“…Radiofrequency ablation seems to prolong survival in inoperable iCCA 256 . Intraductal radiofrequency ablation has been shown to be safe and feasible in the treatment of extrahepatic CCA 257 and seems to be a safe way of improving stent patency 258 . On the other hand, photodynamic therapy can improve survival in patients with unresectable CCA [259][260][261] .…”

Endoscopic radiofrequency biliary ablation treatment: A comprehensive review

“…In one study, hemobilia was reported in three patients of whom two died because of this adverse event . Besides technical success, one study found a significant increase in the diameter of the bile duct after RFA treatment, two studies showed median stent patency of 110 and 170 days, longer for SEMS than for plastic stents, and one study reported a 12.3‐month overall survival …”

Endoscopic ultrasonography and small‐bowel endoscopy: Present and future

“…The feasibility of EUS‐RFA in the treatment of pancreatic lesions has been demonstrated in small case series, including patients with cystic neoplasms and neuroendocrine tumors . In malignant biliary obstruction, RFA can improve the patency of SEMS and patient survival rates . In a systematic review of nine studies and 505 patients, mean difference in stent patency was 50.6 days (95% CI = 32.8–68.5) with improved survival (hazard ratio 1.39, 95% CI = 1.1–1.7) in favor of RFA + SEMS versus SEMS alone .…”

“…In a systematic review of nine studies and 505 patients, mean difference in stent patency was 50.6 days (95% CI = 32.8–68.5) with improved survival (hazard ratio 1.39, 95% CI = 1.1–1.7) in favor of RFA + SEMS versus SEMS alone . Adverse events with biliary RFA include abdominal pain (31%), cholangitis, hemobilia, cholecystitis (that can also occur in SEMS alone) and partial liver infarction as a result of vascular injury . In a randomized trial of 26 patients with pancreatic cancer, EUS‐RFA has recently been compared to traditional celiac‐plexus neurolysis showing more pain relief, improved quality of life and comparable adverse events .…”