Surgical Endoscopy

, Volume 30, Issue 3, pp 1242–1248 | Cite as

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

  • A. Laquière
  • C. Boustière
  • S. Leblanc
  • G. Penaranda
  • E. Désilets
  • F. Prat
Dynamic Manuscript

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.

Keywords

Biliary TRACT neoplasms Catheter ablation Endoscopic retrograde cholangiopancreatography Bile ducts Extrahepatic cholestasis Extrahepatic 

Abbreviations

CCA

Cholangiocarcinoma

RFA

Radiofrequency ablation

ERCP

Endoscopic retrograde cholangiopancreatography

CBD

Common bile duct

Supplementary material

Supplementary material 1 (MOV 120119 kb)

Supplementary material 2 (MOV 187263 kb)

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • A. Laquière
    • 1
  • C. Boustière
    • 1
  • S. Leblanc
    • 2
  • G. Penaranda
    • 3
  • E. Désilets
    • 1
  • F. Prat
    • 2
  1. 1.Hepato-Gastro-Enterology DepartmentSaint Joseph HospitalMarseilleFrance
  2. 2.Gastroenterology DepartmentCochin HospitalParisFrance
  3. 3.Alphabio Biostatistics Lab.European HospitalMarseilleFrance

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