Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma
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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.
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.
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.
Endoscopic radiofrequency treatment of inoperable CCA appears without major risks and is feasible. No major adverse events or biliary fistula were identified.
KeywordsBiliary TRACT neoplasms Catheter ablation Endoscopic retrograde cholangiopancreatography Bile ducts Extrahepatic cholestasis Extrahepatic
Endoscopic retrograde cholangiopancreatography
Common bile duct
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.
Compliance with Ethical Standards
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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