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Impact of Radiofrequency Ablation on Malignant Biliary Strictures: Results of a Collaborative Registry

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Abstract

Background

Radiofrequency ablation of malignant biliary strictures has been offered for the last 3 years, but only limited data have been published.

Aim

To assess the safety, efficacy, and survival outcomes of patients receiving endoscopic radiofrequency ablation.

Methods

Between April 2010 and December 2013, 69 patients with unresectable neoplastic lesions and malignant biliary obstruction underwent 98 radiofrequency ablation sessions with stenting.

Results

A total of 69 patients (22 male, aged 66.1 ± 13.3) were included in the registry. The etiology of malignant biliary stricture included unresectable cholangiocarcinoma (n = 45), pancreatic cancer (n = 19), gallbladder cancer (n = 2), gastric cancer (n = 1), and liver metastasis from colon cancer (n = 3). Seventy-eight percentage of patients had prior chemotherapy. All strictures were stented post-radiofrequency ablation with either plastic stents or metal stents. The mean stricture length treated was 14.3 mm. There was a statistically significant improvement in stricture diameter post-ablation (p < 0.0001). The likelihood of stricture improvement was significantly greater in pancreatic cancer-associated strictures [RR 1.8 (95 % 1.03–5.38)]. Seven patients (10 %) had adverse events, not linked directly to radiofrequency ablation. Median survival was 11.46 months (6.2–25 months).

Conclusion

Radiofrequency ablation is effective and safe in malignant biliary obstruction and seems to be associated with improved survival.

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Conflict of interest

Michel Kahaleh MD has received grant support from Boston Scientific, Fujinon, EMcison, Xlumena Inc., W.L. Gore, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, GI Dynamics, and MI Tech. He is a consultant for Boston Scientific and Xlumena Inc.; Amrita Sethi MD is a consultant for Boston Scientific. All other authors have no conflicts of interest to report.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Weill Cornell Medical College, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA

    Reem Z. Sharaiha, Kristen R. Weaver, Prashant Kedia, Nikhil A. Kumta, Carlos M. Rondon Clavo, Jorge Cerecedo-Rodriguez, Paola Figueroa Barojas, Jessica L. Widmer, Monica Gaidhane & Michel Kahaleh

  2. Gastroenterology, Columbia University Medical Center, New York, NY, USA

    Amrita Sethi & Tamas A. Gonda

  3. Gastroenterology, University of Colorado, Denver, CO, USA

    Raj J. Shah & Norio Fukami

  4. Gastroenterology, University of Washington, Seattle, WA, USA

    Michael D. Saunders

  5. Gastroenterology, Massachusetts General Hospital, Boston, MA, USA

    William R. Brugge

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  1. Reem Z. Sharaiha
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Correspondence to Michel Kahaleh.

Additional information

IRB#1108011875, Approved on 09/13/2011 by WCMC-IRB.

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Sharaiha, R.Z., Sethi, A., Weaver, K.R. et al. Impact of Radiofrequency Ablation on Malignant Biliary Strictures: Results of a Collaborative Registry. Dig Dis Sci 60, 2164–2169 (2015). https://doi.org/10.1007/s10620-015-3558-3

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  • DOI: https://doi.org/10.1007/s10620-015-3558-3

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