Download PDF
Endoscopy 2020; 52(07): 595-599
DOI: 10.1055/a-1133-4448
Innovations and brief communications

Endobiliary radiofrequency ablation combined with bilateral metal stent placement for malignant hilar biliary obstruction

Tadahisa Inoue
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Mayu Ibusuki
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Rena Kitano
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Yuji Kobayashi
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Tomohiko Ohashi
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Yukiomi Nakade
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Yoshio Sumida
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Kiyoaki Ito
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
,
Masashi Yoneda
Department of Gastroenterology, Aichi Medical University, Aichi, Japan
› Author AffiliationsTRIAL REGISTRATION: Single-center observational study UMIN000033458 at http://www.umin.ac.jp
› Further Information
Also available at
    Permissions and Reprints

Referred to by:

Endobiliary radiofrequency ablation: promising but not fully standardizedEndoscopy 2020; 52(07): 535-536
DOI: 10.1055/a-1167-2502

Abstract

Background The effectiveness of endobiliary radiofrequency ablation (RFA) is still uncertain, especially in patients with malignant hilar biliary obstruction (MHBO). We examined the efficacy of endobiliary RFA followed by bilateral self-expandable metal stent (SEMS) placement for unresectable MHBO.

Methods 41 patients met the eligibility criteria for study inclusion. We evaluated the technical success, functional success, and recurrent biliary obstruction (RBO) associated with RFA with bilateral SEMS placement.

Results The technical and functional success rates were both 95.1 % (39/41). The RBO rate was 38.5 % (15/39), and the median time to RBO was 230 days. Stricture length was positively correlated with time to RBO in the multivariate analysis (P = 0.03). The median time to RBO was significantly longer in patients with strictures > 15 mm in length than in those with strictures ≤ 15 mm (314 vs. 156 days; P = 0.02).

Conclusions The present study showed that endobiliary RFA with bilateral SEMS placement achieved good results, but selection of patients with an appropriate stricture length may be needed to obtain a sufficient ablative effect.

Fig. 1s, Table 1s



Publication History

Received: 20 December 2019

Accepted: 17 February 2020

Article published online:
24 March 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Yang J, Wang J, Zhou H. et al. Efficacy and safety of endoscopic radiofrequency ablation for unresectable extrahepatic cholangiocarcinoma: a randomized trial. Endoscopy 2018; 50: 751-760
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Cui W, Wang Y, Fan W. et al. Comparison of intraluminal radiofrequency ablation and stents vs. stents alone in the management of malignant biliary obstruction. Int J Hyperthermia 2017; 33: 853-861
    PubMedSearch in Google Scholar
  • 3 Larghi A, Rimbaş M, Tringali A. et al. Endoscopic radiofrequency biliary ablation treatment: a comprehensive review. Dig Endosc 2019; 31: 245-255
    CrossrefPubMedSearch in Google Scholar
  • 4 Sofi AA, Khan MA, Das A. et al. Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc 2018; 87: 944-951
    CrossrefPubMedSearch in Google Scholar
  • 5 Ortner ME, Caca K, Berr F. et al. Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study. Gastroenterology 2003; 125: 1355-1363
    CrossrefPubMedSearch in Google Scholar
  • 6 Dumonceau JM, Tringali A, Papanikolaou IS. et al. Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline – updated October 2017. Endoscopy 2018; 50: 910-930
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Inoue T, Ishii N, Kobayashi Y. et al. Simultaneous versus sequential side-by-side bilateral metal stent placement for malignant hilar biliary obstructions. Dig Dis Sci 2017; 62: 2542-2549
    CrossrefPubMedSearch in Google Scholar
  • 8 Isayama H, Hamada T, Yasuda I. et al. TOKYO criteria 2014 for transpapillary biliary stenting. Dig Endosc 2015; 27: 259-264
    CrossrefPubMedSearch in Google Scholar
  • 9 Lee YN, Jeong S, Choi HJ. et al. The safety of newly developed automatic temperature-controlled endobiliary radiofrequency ablation system for malignant biliary strictures: a prospective multicenter study. J Gastroenterol Hepatol 2019; 34: 1454-1459
    PubMedSearch in Google Scholar