Skip to main content
SpringerLink
Log in

Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.

Methods

Data from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.

Results

The RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).

Conclusions

Prolongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Zacharoulis D, Lazoura O, Sioka E, Potamianos S, Tzovaras G, Nicholls J, et al. Habib EndoHPB: a novel endobiliary radiofrequency ablation device. An experimental study. J Invest Surg. 2013;26(1):6–10. doi:10.3109/08941939.2012.681832.

    Article  PubMed  Google Scholar 

  2. Wu TT, Li HC, Li WM, Ao GK, Lin H, Zheng F, et al. Percutaneous intraluminal radiofrequency ablation for malignant extrahepatic biliary obstruction: a safe and feasible method. Dig Dis Sci. 2015. doi:10.1007/s10620-015-3547-6.

    PubMed Central  Google Scholar 

  3. Dolak W, Schreiber F, Schwaighofer H, Gschwantler M, Plieschnegger W, Ziachehabi A, et al. Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications. Surg Endosc. 2014;28(3):854–60. doi:10.1007/s00464-013-3232-9.

    Article  PubMed  Google Scholar 

  4. Mizandari M, Pai M, Xi F, Valek V, Tomas A, Quaretti P, et al. Percutaneous intraductal radiofrequency ablation is a safe treatment for malignant biliary obstruction: feasibility and early results. Cardiovasc Interv Radiol. 2013;36(3):814–9. doi:10.1007/s00270-012-0529-3.

    Article  Google Scholar 

  5. Figueroa-Barojas P, Bakhru MR, Habib NA, Ellen K, Millman J, Jamal-Kabani A, et al. Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer: a novel palliation technique. J Oncol. 2013;2013:910897. doi:10.1155/2013/910897.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Li TF, Huang GH, Li Z, Hao CF, Ren JZ, Duan XH, et al. Percutaneous transhepatic cholangiography and intraductal radiofrequency ablation combined with biliary stent placement for malignant biliary obstruction. J Vasc Interv Radiol. 2015;26(5):715–21. doi:10.1016/j.jvir.2015.01.037.

    Article  CAS  PubMed  Google Scholar 

  7. Laquiere A, Boustiere C, Leblanc S, Penaranda G, Desilets E, Prat F. Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma. Surg Endosc. 2015. doi:10.1007/s00464-015-4322-7.

    Google Scholar 

  8. Heffernan N, Cella D, Webster K, Odom L, Martone M, Passik S, et al. Measuring health-related quality of life in patients with hepatobiliary cancers: the functional assessment of cancer therapy-hepatobiliary questionnaire. J Clin Oncol. 2002;20(9):2229–39.

    Article  PubMed  Google Scholar 

  9. Yount S, Cella D, Webster K, Heffernan N, Chang C, Odom L, et al. Assessment of patient-reported clinical outcome in pancreatic and other hepatobiliary cancers: the FACT Hepatobiliary Symptom Index. J Pain Symptom Manag. 2002;24(1):32–44.

    Article  Google Scholar 

  10. Li M, Bai M, Qi X, Li K, Yin Z, Wang J, et al. Percutaneous transhepatic biliary metal stent for malignant hilar obstruction: results and predictive factors for efficacy in 159 patients from a single center. Cardiovasc Interv Radiol. 2015;38(3):709–21. doi:10.1007/s00270-014-0992-0.

    Article  CAS  Google Scholar 

  11. Davids PH, Groen AK, Rauws EA, Tytgat GN, Huibregtse K. Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet. 1992;340(8834–8835):1488–92.

    Article  CAS  PubMed  Google Scholar 

  12. O’Brien S, Hatfield AR, Craig PI, Williams SP. A three year follow up of self expanding metal stents in the endoscopic palliation of longterm survivors with malignant biliary obstruction. Gut. 1995;36(4):618–21.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rossi P, Bezzi M, Rossi M, Adam A, Chetty N, Roddie ME, et al. Metallic stents in malignant biliary obstruction: results of a multicenter European study of 240 patients. J Vasc Interv Radiol. 1994;5(2):279–85.

    Article  CAS  PubMed  Google Scholar 

  14. Zacharoulis D, Tzovaras G, Rountas C, Poultsidis A, Katsogridakis E, Sioka E, et al. Modified radiofrequency-assisted liver resection: a new device. J Surg Oncol. 2007;96(3):254–7. doi:10.1002/jso.20770.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China

    Tian-tian Wu, Wei-min Li & Fang Zheng

  2. Radiology Department, The 309th Hospital of PLA, Beijing, 100091, China

    Guo-kun Ao & Hu Lin

  3. General Surgery Department, The 307th Hospital of PLA, Beijing, 100071, China

    Hu-cheng Li

Authors
  1. Tian-tian Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wei-min Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hu-cheng Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guo-kun Ao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fang Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hu Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tian-tian Wu.

Ethics declarations

Conflict of Interest

All authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

Wei-min Li—Co-first author.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, Tt., Li, Wm., Li, Hc. et al. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life. Cardiovasc Intervent Radiol 40, 260–269 (2017). https://doi.org/10.1007/s00270-016-1483-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-016-1483-2

Keywords

Search

Navigation