Feasibility and safety of percutaneous transhepatic endobiliary radiofrequency ablation as an adjunct to biliary stenting in malignant biliary obstruction.

PURPOSE: The purpose of this study was to investigate the feasibility and safety of percutaneous transhepatic endobiliary radiofrequency ablation (RFA) combined with biliary stenting in palliative treatment of malignant biliary obstructions.

MATERIALS AND METHODS: Twenty-one patients who had undergone percutaneous transhepatic endobiliary RFA as an adjunct to biliary stenting were included. There were 12 men and nine women with a mean age of 67±13.6 (SD) years (range: 34-86 years). Demographic data, procedure details and follow-up data including complications, survival time and stent patency time were documented. The median stent patency time and survival time, as well as the 30- day and 180-day cumulative survival and stent patency rates were estimated using the Kaplan-Meier method.

RESULTS: Twenty-four percutaneous transhepatic endobiliary RFA procedures were performed. There were no procedure-related major complications or death. Three patients who had developed stent reocclusion underwent a second endobiliary RFA, without insertion of a new stent. The most common complications were post-procedural pain and cholangitis. Overall survival and stent patency times ranged between 5-542 days and 5-251 days, respectively. The median survival time was 76 days (95%CI: 0-233 days) and stent patency time was 133 days (95% CI: 25-240 days). The 30- and 180- day cumulative stent patency rates were 75% and 34%, respectively.

CONCLUSION: Percutaneous transhepatic endobiliary RFA is a feasible, safe and cost-effective method in restoration of biliary drainage in patients with malignant biliary obstruction.