title: Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma.
abstract: BACKGROUND
  Biliary bipolar radiofrequency ablation (RFA) is a new treatment for extrahepatic cholangiocarcinoma (CCA) currently under evaluation. The purpose of this study was to evaluate the safety, particularly biliary fistula occurrence, and the feasibility of biliary RFA in a homogeneous group of patients treated using the same RFA protocol.
  
  
  METHODS
  Twelve patients with inoperable or unresectable CCA were included in a bicentric case series study. After removal of biliary plastic stents, a radiofrequency treatment with a new bipolar probe (Habib™ EndoHBP) was applied. The energy was delivered by a RFA generator (VIO 200 D), supplying electrical energy at 350 kHz and 10 W for 90 s. At the end of the procedure, one or more biliary stents were left in place. Adverse events were assessed per-procedure and during follow-up visits.
  
  
  RESULTS
  CCA was confirmed in all patients by histology (66%), locoregional evolution or metastatic evolution. The types of CCA were Bismuth I stage (N = 4), Bismuth II stage (N = 3), Bismuth III stage (N = 2) and Bismuth IV stage (N = 3). No serious adverse events occurred within 30 days following endoscopic treatment: One patient had a sepsis due to bacterial translocation on day 1 and another had an acute cholangitis on day 12 due to early stent migration. No immediate or delayed biliary fistula was reported. The ergonomics of the probe made treatment easy in 100 % of cases. Mean survival was 12.3 months.
  
  
  CONCLUSIONS
  Endoscopic radiofrequency treatment of inoperable CCA appears without major risks and is feasible. No major adverse events or biliary fistula were identified.
authors.affiliation: Hepato-Gastro-Enterology Department, Saint Joseph Hospital, 26 bd de Louvain, 13008, Marseille, France. alaquiere@hopital-saint-joseph.fr.
authors.forename: A
authors.initials: A
authors.lastname: Laquière
authors.affiliation: Hepato-Gastro-Enterology Department, Saint Joseph Hospital, 26 bd de Louvain, 13008, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Boustière
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Leblanc
authors.affiliation: Alphabio Biostatistics Lab., European Hospital, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Penaranda
authors.affiliation: Hepato-Gastro-Enterology Department, Saint Joseph Hospital, 26 bd de Louvain, 13008, Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Désilets
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Prat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D017115:Catheter Ablation; D018281:Cholangiocarcinoma / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents
keywords: Bile ducts; Biliary TRACT neoplasms; Catheter ablation; Endoscopic retrograde cholangiopancreatography; Extrahepatic; Extrahepatic cholestasis