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Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma

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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.

Conclusion

Endoscopic radiofrequency treatment of inoperable CCA appears without major risks and is feasible. No major adverse events or biliary fistula were identified.

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Abbreviations

CCA:

Cholangiocarcinoma

RFA:

Radiofrequency ablation

ERCP:

Endoscopic retrograde cholangiopancreatography

CBD:

Common bile duct

References

  1. Kim M-J, Choi J-Y, Chung YE (2010) Evaluation of biliary malignancies using multidetector-row computed tomography. J Comput Assist Tomogr 34(4):496–505

    Article  PubMed  Google Scholar 

  2. Gore RM, Shelhamer RP (2007) Biliary tract neoplasms: diagnosis and staging. Cancer Imaging 7 Spec No A:S15–S23

  3. Fritcher EG, Kipp BR, Halling KC, Oberg TN, Bryant SC, Tarrell RF, Gores GJ, Levy MJ, Clayton AC, Sebo TJ, Roberts LR (2009) A multivariable model using advanced cytologic methods for the evaluation of indeterminate pancreatobiliary strictures. Gastroenterology 136(7):2180–2186

    Article  PubMed  Google Scholar 

  4. Farrell RJ, Jain AK, Brandwein SL, Wang H, Chuttani R, Pleskow DK (2001) The combination of stricture dilation, endoscopic needle aspiration, and biliary brushings significantly improves diagnostic yield from malignant bile duct strictures. Gastrointest Endosc 54(5):587–594

    Article  CAS  PubMed  Google Scholar 

  5. Chen YK, Pleskow DK (2007) SpyGlass single-operator peroralcholangiopancreatoscopy system for the diagnosis and therapy of bile-duct disorders: a clinical feasibility study (with video). Gastrointest Endosc 65(6):832–841

    Article  PubMed  Google Scholar 

  6. Garrow D, Miller S, Sinha D, Conway J, Hoffman BJ, Hawes RH, Romagnuolo J (2007) Endoscopic ultrasound: a meta-analysis of test performance in suspected biliary obstruction. Clin Gastroenterol Hepatol 5(5):616–623

    Article  PubMed  Google Scholar 

  7. Ortner MEJ, Caca K, Berr F, Liebetruth J, Mansmann U, Huster D, Voderholzer W, Schachschal G, Mössner J, Lochs H (2003) Successful photodynamic therapy for nonresectablecholangiocarcinoma: a randomized prospective study. Gastroenterology 125(5):1355–1363

    Article  PubMed  Google Scholar 

  8. Deviere J, Baize M, de Toeuf J, Cremer M (1988) Long-term follow-up of patients with hilar malignant stricture treated by endoscopic internal biliary drainage. Gastrointest Endosc 34(2):95–101

    Article  CAS  PubMed  Google Scholar 

  9. Steel AW, Postgate AJ, Khorsandi S, Nicholls J, Jiao L, Vlavianos P, Habib N, Westaby D (2011) Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction. Gastrointest Endosc 73(1):149–153

    Article  PubMed  Google Scholar 

  10. Dolak W, Schreiber F, Schwaighofer H, Gschwantler M, Plieschnegger W, Ziachehabi A, Mayer A, Kramer L, Kopecky A, Schrutka-Kölbl C, Wolkersdörfer G, Madl C, Berr F, Trauner M, Püspök A (2014) Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications. Surg Endosc 28(3):854–860

    Article  PubMed  Google Scholar 

  11. Tal AO, Vermehren J, Friedrich-Rust M, Bojunga J, Sarrazin C, Zeuzem S, Trojan J, Albert JG (2014) Intraductal endoscopic radiofrequency ablation for the treatment of hilar non-resectable malignant bile duct obstruction. World J Gastrointest Endosc 6(1):13–19

    Article  PubMed Central  PubMed  Google Scholar 

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

    Article  PubMed Central  PubMed  Google Scholar 

  13. Marsh Rde W, Alonzo M, Bajaj S, Baker M, Elton E, Farrell TA, Gore RM, Hall C, Nowak J, Roy H, Shaikh A, Talamonti MS (2012) Comprehensive review of the diagnosis and treatment of biliary tract cancer. Part I: diagnosis-clinical staging and pathology. J Surg Oncol 106(3):332–338

    Article  PubMed  Google Scholar 

  14. Itoi T, Isayama H, Sofuni A, Itokawa F, Tamura M, Watanabe Y, Moriyasu F, Kahaleh M, Habib N, Nagao T, Yokoyama T, Kasuya K, Kawakami H (2012) Evaluation of effects of a novel endoscopically applied radiofrequency ablation biliary catheter using an ex vivo pig liver. J Hepatobil Pancreat Sci 19(5):543–547

    Article  Google Scholar 

  15. Ducreux M, Van Cutsem E, Van Laethem JL, Gress TM, Jeziorski K, Rougier P, Wagener T, Anak O, Baron B, Nordlinger B (2005) A randomised phase II trial of weekly high-dose 5-fluorouracil with and without folinic acid and cisplatin in patients with advanced biliary tract carcinoma: results of the 40955 EORTC trial. Eur J Cancer 41:398–403

    Article  CAS  PubMed  Google Scholar 

  16. André T, Tournigand C, Rosmorduc O, Provent S, Maindrault-Goebel F, Avenin D, Selle F, Paye F, Hannoun L, Houry S, Gayet B, Lotz JP, de Gramont A, Louvet C (2004) Gemcitabine combined with oxaliplatine (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study. Ann Oncol 15:1339–1343

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the patients and the nurses for their important contribution, Terri Galli for the English translation, Laurence Curel and Laurence Lecomte for their support and review during the publication process.

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Authors and Affiliations

  1. Hepato-Gastro-Enterology Department, Saint Joseph Hospital, 26 bd de Louvain, 13008, Marseille, France

    A. Laquière, C. Boustière & E. Désilets

  2. Gastroenterology Department, Cochin Hospital, Paris, France

    S. Leblanc & F. Prat

  3. Alphabio Biostatistics Lab., European Hospital, Marseille, France

    G. Penaranda

Authors
  1. A. Laquière
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  2. C. Boustière
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  3. S. Leblanc
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  4. G. Penaranda
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  5. E. Désilets
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  6. F. Prat
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Correspondence to A. Laquière.

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Disclosures

A. Laquière, C. Boustière, S. Leblanc, G. Penaranda, E. Désilets, F. Prat have no conflict of interest to disclose either related to product or companies named in the article or to competing products or companies. The funding of the study was independent and has been supported by each hospital own investments.

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Laquière, A., Boustière, C., Leblanc, S. et al. Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma. Surg Endosc 30, 1242–1248 (2016). https://doi.org/10.1007/s00464-015-4322-7

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  • DOI: https://doi.org/10.1007/s00464-015-4322-7

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