The effect of percutaneous endobiliary radiofrequency ablation on biliary stent patency

ObjectiveThis study investigated whether endobiliary radiofrequency ablation (eRFA) performed before stent placement benefited the patency of self-expandable metal stents placed in patients with unresectable malignant biliary obstruction.MethodsThe study included 94 patients with biliary malignancies who underwent percutaneous biliary stent placement. The mean age of the patients was 66.9 ± 10.7 years, with 60 males (63.8%). Forty-five patients (47.9%) underwent eRFA (ELRA^TM, STARmed, Republic of Korea) before stenting. The patients' age, gender, type of cancer, laboratory values (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and gamma-glutamyl transferase [GGT]), Bismuth-Corlette classification of tumors, and stent patency were retrospectively analyzed. The study's primary objective was to evaluate the impact of pre-stenting ELRA therapy on stent patency. Secondary objectives included comparing changes in post-procedural biochemical parameters, complication rates, and other parameters between the ELRA and non-ELRA groups.ResultsThe median follow-up was 17 months. Technical success was 100% in both groups, with no procedure-related major complications or mortality. Minor complications included fever and mild abdominal pain, with no significant difference between the groups. Post-procedure total bilirubin, ALT, AST, and GGT levels significantly decreased compared to pre-procedure values in the ELRA group. In contrast, no significant difference was observed in the non-ELRA group. The median duration of primary patency was 6 months for all patients, significantly longer in the ELRA group compared to the non-ELRA group (8 vs. 6 months, p < 0.001).ConclusioneRFA performed using the ELRA catheter before biliary stenting is a technically successful, minimally invasive, and safe procedure that can potentially increase the duration of stent patency.