title: Intraductal radiofrequency ablation for refractory benign biliary stricture: pilot feasibility study.
abstract: OBJECTIVE
  Endoscopic management of benign biliary stricture (BBS) remains challenging. There is no reported method for the amelioration of biliary fibroplasia endoscopically. We report our initial experience of radiofrequency ablation (RFA) for the management of BBS.
  
  
  METHODS
  Nine patients with BBS (postoperation stricture four, liver transplant three, and chronic inflammation two), seven of whom had previously unsuccessful endoscopic or percutaneous interventions, were enrolled. Intraductal bipolar RFA was delivered at power of 10 W for 90 s per stricture segment, followed by balloon dilatation with/without stent placement.
  
  
  RESULTS
  All patients had immediate stricture improvements after RFA. No severe adverse event occurred except for one patient with mild post-endoscopic retrograde cholangiopancreatography pancreatitis. During median (SD) follow-up duration of 12.6 (3.9) months, BBS resolution without the need for further stenting was achieved in four patients whereas two patients had stent(s) in situ waiting scheduled removal. However, one patient had stricture relapse after initial resolution, one underwent surgery, and another patient died of other cause.
  
  
  CONCLUSIONS
  Endobiliary RFA appears to be safe and effective for the treatment of BBS, especially for refractory cases. Further studies are warranted.
authors.affiliation: Department of Endoscopy, Eastern Hepatobiliary Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Hu
authors.forename: Dao-Jian
authors.initials: DJ
authors.lastname: Gao
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wang
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Yang
authors.forename: Xin
authors.initials: X
authors.lastname: Ye
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic; D004106:Dilatation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications; D015607:Stents; D016896:Treatment Outcome
keywords: biliary stricture; endoscopic retrograde cholangiopancreatography (ERCP); radiofrequency ablation (RFA); self-expandable metallic stent (SEMS)