Intraductal Radiofrequency Ablation as a Palliative Treatment for Advanced Malignant Hilar Biliary Obstruction
10.3904/kjm.2022.97.3.164
- Author:
Huapyong KANG
1
;
Eui Joo KIM
;
Yeon Suk KIM
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- Publication Type:16
- From:Korean Journal of Medicine
2022;97(3):164-170
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Malignant hilar biliary obstruction (MHBO) frequently accompanies cholestasis and cholangitis, and requires biliary stent placement. To prevent stent occlusion and prolong survival, local ablation therapy can be considered adjunctive to stent placement. Intraductal radiofrequency ablation (ID-RFA) is a recently developed local therapy for malignant biliary obstruction that can be easily performed employing endoscopic retrograde cholangiography. The use of ID-RFA to treat MHBO (as distinct from distal biliary obstruction) was suggested to be associated with severe adverse events. However, recent comparative studies have shown that ID-RFA is feasible and safe, and acceptably efficacious, in patients with advanced MHBO; newer temperature-controlled ID-RFA devices may enhance safety further. Regularly repeated ID-RFA with stent exchange affords better survival than stenting alone. However, the optimal ID-RFA strategy for MHBO remains inconclusive given the lack of data. Further large-scale clinical trials are needed.
