Surgical Endoscopy

, Volume 28, Issue 3, pp 854–860 | Cite as

Endoscopic radiofrequency ablation for malignant biliary obstruction: a nationwide retrospective study of 84 consecutive applications

  • Werner Dolak
  • Florian Schreiber
  • Hubert Schwaighofer
  • Michael Gschwantler
  • Wolfgang Plieschnegger
  • Alexander Ziachehabi
  • Andreas Mayer
  • Ludwig Kramer
  • Andreas Kopecky
  • Christiane Schrutka-Kölbl
  • Gernot Wolkersdörfer
  • Christian Madl
  • Frieder Berr
  • Michael Trauner
  • Andreas Püspök
  • for the Austrian Biliary RFA Study Group
Article

Abstract

Background

Biliary radiofrequency ablation (RFA) using the Habib™ EndoHBP catheter is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to assess the feasibility and safety of this technique.

Methods

In this nationwide retrospective study of prospectively collected clinical data, all patients treated by biliary RFA in Austria between November 2010 and December 2012 were included. Procedure-related complications, adverse events within 30 days post-intervention, stent patency, and mortality rates were investigated.

Results

A total of 58 patients (31 male, 27 female, median age 75 years) underwent 84 RFA procedures at 11 Austrian referral centers for biliary endoscopy. The predominant underlying condition was Klatskin tumor (45 of 58 cases). All 84 RFA procedures were feasible without technical problems. A partial liver infarction was induced by RFA in a 49-year-old Klatskin tumor patient. During 30 days after each RFA procedure, five cases of cholangitis, three cases of hemobilia, two cases of cholangiosepsis, and one case each of gallbladder empyema, hepatic coma, and newly diagnosed left bundle branch block occurred. Median stent patency after last electively performed RFA was 170 days (95 % CI 63–277) and was almost significantly different between metal and plastic stenting (218 vs. 115 days; p = 0.051). Median survival was 10.6 months (95 % CI 6.9–14.4) from the time of the first RFA in each patient and 17.9 months (95 % CI 10.3–25.6) from the time of initial diagnosis.

Conclusions

Except for one severe interventional complication (hepatic infarct), RFA presented as a technically feasible and safe therapeutic option for the palliative treatment of malignant biliary obstruction. The good results of stent patency and survival in this study should be proven in prospective (controlled) trials to further quantify the efficacy of this promising new technique.

Keywords

Malignant biliary obstruction Endoscopic radiofrequency ablation Endoscopic retrograde cholangiopancreatography Therapeutic endoscopy Hilar cholangiocarcinoma 

Supplementary material

464_2013_3232_MOESM1_ESM.doc (133 kb)
Supplementary table Patient characteristics per patient. (DOC 133 kb)

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Werner Dolak
    • 1
  • Florian Schreiber
    • 2
  • Hubert Schwaighofer
    • 3
  • Michael Gschwantler
    • 4
  • Wolfgang Plieschnegger
    • 5
  • Alexander Ziachehabi
    • 6
  • Andreas Mayer
    • 7
  • Ludwig Kramer
    • 8
  • Andreas Kopecky
    • 9
  • Christiane Schrutka-Kölbl
    • 10
  • Gernot Wolkersdörfer
    • 11
  • Christian Madl
    • 10
  • Frieder Berr
    • 11
  • Michael Trauner
    • 1
  • Andreas Püspök
    • 1
  • for the Austrian Biliary RFA Study Group
  1. 1.Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
  2. 2.Division of Gastroenterology and Hepatology, Department of Internal MedicineMedical University of GrazGrazAustria
  3. 3.Department of Internal Medicine IIMedical University of InnsbruckInnsbruckAustria
  4. 4.Department of Internal Medicine IVWilhelminenspitalViennaAustria
  5. 5.Department of Internal MedicineBarmherzige BrüderSt Veit an der GlanAustria
  6. 6.Department of Internal Medicine IVKrankenhaus der Elisabethinen LinzLinzAustria
  7. 7.Department of Internal Medicine IILandesklinikumSt PöltenAustria
  8. 8.Department of Internal Medicine IKrankenhaus HietzingViennaAustria
  9. 9.Department of Internal MedicineLandesklinikum Thermenregion BadenBadenAustria
  10. 10.Department of Internal Medicine IVKrankenanstalt RudolfstiftungViennaAustria
  11. 11.Department of Internal Medicine IParacelsus Medical UniversitySalzburgAustria

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