Korean Journal of Pancreas and Biliary Tract  2015;20(3):140-145

doi:10.15279/kpba.2015.20.3.140

A Case of Direct Peroral Cholangioscopy-Guided Intraductal Radiofrequency Ablation for Malignancy Biliary Obstruction via Choledochoduodenostomy Orifice.

Jin Suk KANG 1 ; Dong Uk KIM ; Jeong Eun LEE ; Min Ji KIM ; Geun Am SONG ; Jeong HEO ; Dong Hoon BAEK ; Tae Wook KIM

Affiliations

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Keywords

Cholangiocarcinoma; Intraductal radiofrequency ablation; Direct peroral cholangioscopy

Country

Republic of Korea

Language

Korean

Abstract

BAlthough intraductal radiofrequency ablation (RFA) has been reported to be a feasible treatment of malignancy biliary obstruction in unresectable cholangiocarcinoma, endoscopic retrograde cholangiopancreatography (ERCP)-guided intraductal RFA has a disadvantage that cannot be directly visualize the biliary tract using the fluoroscopic image. On the other hand, direct peroral cholangioscopy-guided intraductal RFA is easy to insert catheter and apply treatment by visualizing the bile duct lesions. We present a case of direct peroral cholangioscopy-guided intraductal RFA without biliary stent in 67-year-old woman patient with cholangiocarcinoma for treatment of malignancy biliary obstruction. In the past, she underwent choledochoduodenostomy for intrahepatic stones. She underwent direct peroral cholangioscopy-guided intraductal RFA via choledochoduodenostomy orifice, and biliary patency was preserved for 90days without additional treatment such as biliary stent and severe complication. Direct peroral cholangioscopy-guided intraductal RFA is expected to be able to reduce the complications of the procedure by ensuring the bile duct lesions. Prospective studies with long term follow up are warranted.