Endobiliary radiofrequency ablation for malignant biliary obstruction.
BACKGROUND
The cornerstone of palliative treatment for inoperable extrahepatic cholangiocarcinoma is the relief of malignant biliary obstruction. The most commonly applied method is endoscopic stenting. However, the procedure can be complicated with stent obstruction. In this respect, endobiliary radiofrequency ablation may serve as an adjunctive tool for prolonging the stent patency.


METHODS
Patients who underwent endoscopic retrograde cholangiopancreatography for differential diagnosis and/or palliative treatment after the diagnosis of inoperable extrahepatic cholangiocarcinoma between March 2011 and January 2012 were analyzed. Those in whom endobiliary radiofrequency ablation and endoscopic stenting was successfully performed were included in the study. Technical details of the procedure, duration of stent patency, length of hospital stay, short-term morbidity and mortality rate were documented.


RESULTS
Seventeen patients were analyzed, and 10 patients were included in the study. The morbidity and mortality rate within the first 30 days after the procedure was 20% and 0%, respectively. In 2 patients, mild pancreatitis occurred because of the endobiliary procedure. In 1 patient, endobiliary decompression could not be achieved, and therefore, percutaneous transhepatic biliary drainage was carried out. The median duration of stent patency in 9 patients with successful biliary decompression was 9 months (range 6-15).


CONCLUSIONS
Endobiliary radiofrequency ablation seems to be safe and feasible as a palliative measure and may prolong the stent patency and overall survival in patients with malignant biliary obstruction due to inoperable extrahepatic cholangiocarcinoma.
General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey. halilalis@gmail.com
Halil
H
Alis
Cetin
C
Sengoz
Murat
M
Gonenc
Mustafa Uygar
MU
Kalayci
Ali
A
Kocatas
D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications*; D017734:Bile Ducts, Extrahepatic; D017115:Catheter Ablation / Q000009:adverse effects; D018281:Cholangiocarcinoma / Q000150:complications*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010195:Pancreatitis / Q000209:etiology; D012189:Retrospective Studies; D015607:Stents