Percutaneous Endobiliary Radiofrequency Ablation (PERFA) for Unresectable Cholangiocarcinoma

Area of Science:

• Interventional Radiology
• Oncology
• Hepatobiliary Surgery

Background:

• Cholangiocarcinoma (CCA) is an aggressive cancer often diagnosed at advanced stages, limiting curative treatment options.
• Palliative interventions are crucial for managing biliary obstruction in unresectable CCA patients.
• Endobiliary radiofrequency ablation (RFA) shows potential for improving biliary patency, but its percutaneous application requires further investigation.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous endobiliary RFA using the Habib™ EndoHPB probe in patients with unresectable CCA.
• To assess technical success, clinical outcomes, laboratory trends, and adverse events associated with the procedure.
• To determine the impact of RFA on interventional radiology service utilization and drain management.

Main Methods:

• Retrospective review of eight patients with unresectable intrahepatic/perihilar CCA undergoing percutaneous endobiliary RFA.
• Data collection included technical and clinical success rates, laboratory values (bilirubin, AST, ALT), adverse events, and follow-up duration.
• Clinical success was defined by bilirubin reduction and symptom improvement within one month post-procedure.

Main Results:

• 100% technical success rate was achieved in all patients.
• Clinical success, marked by significant bilirubin reduction and symptom resolution, was observed in 87.5% of patients.
• No major adverse events were reported; liver enzymes (AST/ALT) showed significant improvement, and drain exchange intervals extended post-RFA.

Conclusions:

• Percutaneous endobiliary RFA with the Habib probe is a safe and technically feasible palliative treatment for unresectable CCA.
• The procedure demonstrates favorable laboratory and clinical outcomes, including improved liver function and reduced need for frequent drain management.
• Endobiliary RFA represents a valuable adjunct in the management of biliary obstruction in advanced CCA, warranting further prospective studies.