Percutaneous Intraluminal Radiofrequency Ablation for Malignant Extrahepatic Biliary Obstruction: A Safe and Feasible...

The Habib™ EndoHBP catheter is a novel bipolar radiofrequency catheter developed for intraluminal ablation to relieve malignant extrahepatic biliary obstruction. Clinical experience with its use is limited and scattered.

The purpose of this study was to evaluate the clinical feasibility and safety of this technique.

A single central retrospective analysis was performed with patients who underwent percutaneous intraluminal radiofrequency ablation (RFA) combined with biliary stenting for treatment of extrahepatic obstructive jaundice between September 2011 and May 2014. A Habib™ EndoHBP catheter was used for RFA. Clinical and telephonic follow-ups were carried out. Procedure-related complications, stent patency, patient survival rate and postoperative biochemical tests were investigated.

All the 47 patients tolerated well a total of 65 RFA procedures with self-expandable metal stents placed. The predominant disease was distal cholangiocarcinoma (16 of 47 cases). No procedure-related hemobilia or infections occurred. The main postablation complication was pain which could be controlled by analgesics. One patient suffered abdominal hemorrhage, diagnosed by blood test and abdominal ultrasonography and cured with conservative therapy. Significantly decreased TBIL and DBIL levels (P < 0.05) were observed on day 7 postoperatively. Stent patency was 149 days (15-281). Median survival was 181 days (15-495) from the time of the first RFA in each patient.

Percutaneous intraluminal RFA combined with biliary stenting is a safe and feasible therapeutic option for unresectable extrahepatic malignant biliary obstruction. Multiple central prospective controlled trials are necessary for the long-term benefits of RFA.