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Endoscopic Procedures V: ERCP

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Related Experiment Video

Updated: Jan 12, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Endobiliary radiofrequency ablation for malignant biliary obstruction.

Hirofumi Yamazaki¹, Yasunobu Yamashita¹, Masayuki Kitano²

¹Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.

Therapeutic Advances in Gastroenterology

|November 3, 2025

Summary

Endoscopic radiofrequency ablation (eRFA) shows promise for malignant biliary obstruction (MBO), improving survival when combined with stenting or chemotherapy. Further research is needed to confirm its efficacy.

Keywords:

ampullary tumor biliary tract cancer endoscopic radiofrequency ablation malignant biliary obstruction overall survival stent patency

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Published on: December 20, 2024

Area of Science:

Gastroenterology
Interventional Oncology
Biliary Interventions

Background:

Malignant biliary obstruction (MBO) is a serious condition often managed with percutaneous or endoscopic interventions.
Radiofrequency ablation (RFA) and endoscopic radiofrequency ablation (eRFA) are emerging techniques for MBO.
Current evidence for eRFA is largely based on retrospective studies, necessitating further investigation.

Purpose of the Study:

To summarize and clarify the current status and applications of radiofrequency ablation for malignant biliary obstruction.
To review the efficacy of endoscopic radiofrequency ablation in various clinical scenarios.
To identify areas for future research in eRFA for MBO.

Main Methods:

Systematic review and meta-analysis of existing studies on eRFA for MBO.
Analysis of eRFA in combination with biliary stenting and chemotherapy.
Evaluation of eRFA for occluded self-expandable metal stents (SEMSs) and inoperable ampullary tumors.

Main Results:

eRFA with biliary stenting improved overall survival at 6 months but not stent patency.
Combination of eRFA and chemotherapy improved overall survival and progression-free survival in locally-advanced biliary tract cancer.
eRFA extended time to recurrent obstruction for occluded SEMSs and improved outcomes for inoperable ampullary tumors.

Conclusions:

eRFA demonstrates therapeutic effects in various applications for MBO, including improved survival and symptom management.
While promising, further large-scale prospective studies are required to strengthen the evidence base for eRFA.
Future research should explore synergistic effects, such as combining eRFA with immune-checkpoint inhibitors.