TY - JOUR
T1 - Endoscopic radiofrequency biliary ablation treatment: a comprehensive review
AU - Larghi, Alberto Leonardo
AU - Rimbaș, Mihai
AU - Tringali, Andrea
AU - Boskoski, Ivo
AU - Rizzatti, Gianenrico
AU - Costamagna, Guido
PY - 2018
Y1 - 2018
N2 - Radiofrequency ablation (RFA) acts by delivering thermal energy within the tissue, the result of a high-frequency alternating current released from an active electrode, leading to coagulative necrosis and cellular death. Recently, a biliary catheter working on a guide-wire has been developed and a number of studies have been performed so far. The present paper provides a comprehensive review of the literature on the results of the use of RFA for the clinical management of patients with unresectable malignant biliary strictures, benign biliary strictures, and residual adenomatous tissue in the bile duct after endoscopic papillectomy. The available data show that biliary RFA treatment is a promising adjuvant therapy in patients with unresectable malignant biliary obstruction. The procedure is safe, well tolerated and improves stent patency and survival, even though more studies are warranted. In patients with residual endobiliary adenomatous tissue after endoscopic papillectomy, a significant rate of neoplasia eradication after a single RFA session has been reported, thus favoring this treatment over surgical intervention. In these patients, as well as, in those with benign biliary strictures, dedicated probes with a short electrode able to focus the RF current on the short stenosis are needed to expand RFA treatment for these indications.
AB - Radiofrequency ablation (RFA) acts by delivering thermal energy within the tissue, the result of a high-frequency alternating current released from an active electrode, leading to coagulative necrosis and cellular death. Recently, a biliary catheter working on a guide-wire has been developed and a number of studies have been performed so far. The present paper provides a comprehensive review of the literature on the results of the use of RFA for the clinical management of patients with unresectable malignant biliary strictures, benign biliary strictures, and residual adenomatous tissue in the bile duct after endoscopic papillectomy. The available data show that biliary RFA treatment is a promising adjuvant therapy in patients with unresectable malignant biliary obstruction. The procedure is safe, well tolerated and improves stent patency and survival, even though more studies are warranted. In patients with residual endobiliary adenomatous tissue after endoscopic papillectomy, a significant rate of neoplasia eradication after a single RFA session has been reported, thus favoring this treatment over surgical intervention. In these patients, as well as, in those with benign biliary strictures, dedicated probes with a short electrode able to focus the RF current on the short stenosis are needed to expand RFA treatment for these indications.
KW - ERCP
KW - Personalized medicine
KW - biliary strictures
KW - cholangiocarcinoma
KW - endoscopic radiofrequency ablation
KW - residual ampullary adenoma
KW - ERCP
KW - Personalized medicine
KW - biliary strictures
KW - cholangiocarcinoma
KW - endoscopic radiofrequency ablation
KW - residual ampullary adenoma
UR - http://hdl.handle.net/10807/127397
U2 - 10.1111/den.13298
DO - 10.1111/den.13298
M3 - Article
SN - 0915-5635
SP - N/A-N/A
JO - Digestive Endoscopy
JF - Digestive Endoscopy
ER -