Safety and efficacy of percutaneous intraductal radiofrequency ablation followed by dual stent placement for malignant biliary hilar obstrction

To evaluate the safety and clinical efficacy of percutaneous intraductal radiofrequency ablation (RFA) followed by dual stent placement in advanced malignant biliary hilar duct obstruction. Between September 2013 and August 2015, ten patients with malignant biliary hilar duct obstruction who underwent percutaneous intraductal RFA followed by dual stent placement were included in this retrospective study. Technical success, clinical success, procedure-related complications, stent patency, and patient's survival durations after treatment were investigated. Percutaneous intraductal RFA followed by dual stent placement was successful in all patients; the technical success rate was 100%. No major complications were identified. After the procedure, serum total bilirubin levels were notably normalized, and therefore, percutaneous transhepatic biliary drainage (PTBD) catheter was successfully removed in 8 patients; the clinical success rate was 80%. Four patients with stent dysfunction associated with tumor ingrowth/overgrowth underwent a repeat PTBD procedure or secondary stent insertion. Mean stent patency and survival durations were 233.8 ± 35.6 days [95% confidence interval (CI), 164.0–303.5 days] and 387.2 ± 114.6 days (95% CI, 162.6–611.8 days), respectively. Percutaneous intraductal RFA combined with dual stent placement in advanced malignant biliary hilar duct obstruction is a safe and feasible palliative treatment option