Journal of Gastrointestinal Cancer

, Volume 45, Supplement 1, pp 55–57 | Cite as

Successful Percutaneous Endobiliary Radiofrequency Ablation for Unresectable Malignant Biliary Obstruction: A Case Report and Review of the Literature

  • Eric J. MaoEmail author
  • James B. Watson
  • Gregory Soares
  • Fadlallah G. Habr
Case Report


Periampullary adenocarcinoma (PA) is a rare cause of gastrointestinal malignancy [1]. Surgical resection remains the only chance for cure [2]; however, even with surgery, 5-year overall survival ranges from 28 to 38 % [3, 4]. Unfortunately, up to 80 % of PAs present at an advanced stage and are surgically unresectable [5]. Biliary obstruction is a frequent manifestation of PA. A multidisciplinary team including oncologists, surgeons, gastroenterologists, and interventional radiologists usually manages PA [6]. Traditionally, endoscopy has been used to relieve malignant biliary obstruction using self-expanding metal stents (SEMSs) [7]. Recently, interventional endoscopy has been employed to deliver direct therapy, such as brachytherapy or photodynamic therapy, to tumors to relieve biliary obstruction [6]. Endobiliary radiofrequency ablation (RFA) is a novel technique that delivers heat energy directly to neoplastic tissues to achieve tumor necrosis and prolong biliary...


Common Bile Duct Biliary Obstruction SEMS Placement Malignant Biliary Obstruction Tumor Ingrowth 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of Interest

The authors have no conflict of interest to declare.


  1. 1.
    Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Gurusamy KS, Kumar S. Davidson BR Prophylactic gastrojejunostomy for unresectable periampullary carcinoma. Cochrane Database Syst Rev. 2010;10:CD008533. doi: 10.1002/14651858.CD008533.pub2.PubMedGoogle Scholar
  3. 3.
    Yeo CJ, Sohn TA, Cameron JL, Hruban RH, Lillemoe KD, Pitt HA. Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg. 1998;227(6):821–31.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Onkendi EO, Boostrom SY, Sarr MG, Farnell MB, Nagorney DM, Donohue JH, et al. 15-year experience with surgical treatment of duodenal carcinoma: a comparison of periampullary and extra-ampullary duodenal carcinomas. J Gastrointest Surg. 2012;16(4):682–91. doi: 10.1007/s11605-011-1808-z.PubMedCrossRefGoogle Scholar
  5. 5.
    Michelassi F, Erroi F, Dawson PJ, Pietrabissa A, Noda S, Handcock M, et al. Experience with 647 consecutive tumors of the duodenum, ampulla, head of the pancreas, and distal common bile duct. Annals of Surgery. 1989;210(4):544–54.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Marsh Rde W, Alonzo M, Bajaj S, Baker M, Elton E, Farrell TA, et al. Comprehensive review of the diagnosis and treatment of biliary tract cancer 2012. Part II: multidisciplinary management. J Surg Oncol. 2012;106(3):339–45. doi: 10.1002/jso.23027.PubMedCrossRefGoogle Scholar
  7. 7.
    Shepherd HA, Royle G, Ross AP, et al. Endoscopic biliary endoprosthesis in the palliation of malignant obstruction of the distal common bile duct: a randomized trial. Br J Surg. 1988;75:1166–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Cho YK, Kim JK, Kim MY, et al. Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies. Hepatology. 2009;49:453–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Mulier S, Ruers T, Jamart J, et al. Radiofrequency ablation versus resection for resectable colorectal liver metastases: time for a randomized trial? An update. Dig Surg. 2008;25:445–60.PubMedCrossRefGoogle Scholar
  10. 10.
    Steel AW, Postgate AJ, Khorsandi S, Nicholls J, Jiao L, Vlavianos P, et al. Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction. Gastrointest Endosc. 2011;73(1):149–53. doi: 10.1016/j.gie.2010.09.031.PubMedCrossRefGoogle Scholar
  11. 11.
    Itoi T, Isayama H, Sofuni A, et al. Evaluation of effects of a novel endoscopically applied radiofrequency ablation biliary catheter using an ex-vivo pig liver. J Hepatobiliary Pancreat Sci. 2012;19:543–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Zacharoulis D, Lazoura O, Sioka E, et al. Habib EndoHPB: a novel endobiliary radiofrequency ablation device. An experimental study. J Invest Surg. 2013;26:6–10.PubMedCrossRefGoogle Scholar
  13. 13.
    Figueroa-Barojas P, Bakhru MR, Habib N, et al. Safety and efficacy of radiofrequency ablation in the management of unresectable bile duct and pancreatic cancer: a novel palliation technique. Gastrointest Endosc. 2011;73(4S):AB127.Google Scholar
  14. 14.
    Watson JB, Habr FG. Safety and efficacy of endoscopic radiofrequency ablation in non-resectable cholangiocarcinoma, a case series. Program No. P108. ACG 2012 Annual Scientific Meeting Abstracts. Las Vegas: American College of Gastroenterology; 2012Google Scholar
  15. 15.
    Mizandari M, Pai M, Xi F, Valek V, Tomas A, Quaretti P, et al. Percutaneous intraductal radiofrequency ablation is a safe treatment for malignant biliary obstruction: feasibility and early results. Cardiovasc Intervent Radiol. 2012;36(3):814–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Mukund A, Arora A, Rajesh S, et al. Endobiliary radiofrequency ablation for reopening of occluded biliary stents: a promising technique. J Vasc Interv Radiol. 2013;24:142–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Pozsár J, Tarpay Á, Burai J, Pap Á. Intraductal radiofrequency ablation can restore patency of occluded biliary self-expanding metal stents. Z Gastroenterol. 2011;49:A70.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Eric J. Mao
    • 1
    Email author
  • James B. Watson
    • 2
  • Gregory Soares
    • 3
  • Fadlallah G. Habr
    • 2
  1. 1.Department of Internal MedicineRhode Island HospitalProvidenceUSA
  2. 2.Department of GastroenterologyRhode Island HospitalProvidenceUSA
  3. 3.Department of Interventional RadiologyRhode Island HospitalProvidenceUSA

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