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Endoscopic radiofrequency ablation for malignant biliary obstruction
Cholangiocarcinoma and pancreatic cancer are the most common causes of malignant biliary obstruction. The majority of patients are diagnosed at a late stage when surgical resection is rarely possible. In these cases, palliative chemotherapy and radiotherapy provide only limited benefit and are assoc...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529920/ https://www.ncbi.nlm.nih.gov/pubmed/34721772 http://dx.doi.org/10.4251/wjgo.v13.i10.1383 |
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author | Jarosova, Jana Macinga, Peter Hujova, Alzbeta Kral, Jan Urban, Ondrej Spicak, Julius Hucl, Tomas |
author_facet | Jarosova, Jana Macinga, Peter Hujova, Alzbeta Kral, Jan Urban, Ondrej Spicak, Julius Hucl, Tomas |
author_sort | Jarosova, Jana |
collection | PubMed |
description | Cholangiocarcinoma and pancreatic cancer are the most common causes of malignant biliary obstruction. The majority of patients are diagnosed at a late stage when surgical resection is rarely possible. In these cases, palliative chemotherapy and radiotherapy provide only limited benefit and are associated with poor survival. Radiofrequency ablation (RFA) is a procedure for locoregional control of tumours, whereby a high-frequency alternating current turned into thermal energy causes coagulative necrosis of the tissue surrounding the catheter. The subsequent release of debris and tumour antigens by necrotic cells can stimulate local and systemic immunity. The development of endoluminal RFA catheters has led to the emergence of endoscopically delivered RFA, a treatment mainly used for malignant biliary strictures to prolong survival and/or stent patency. Other indications include recanalisation of occluded biliary stents and treatment of intraductal ampullary adenoma or benign biliary strictures. This article presents a comprehensive review of endobiliary RFA, mainly focusing on its use in patients with malignant biliary obstruction. The available data suggest that biliary RFA may be a promising modality, having positive impacts on survival and stent patency and boasting a reasonable safety profile. However, further studies with better characterised and stratified patient populations are needed before the method becomes accepted within routine clinical practice. |
format | Online Article Text |
id | pubmed-8529920 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-85299202021-10-28 Endoscopic radiofrequency ablation for malignant biliary obstruction Jarosova, Jana Macinga, Peter Hujova, Alzbeta Kral, Jan Urban, Ondrej Spicak, Julius Hucl, Tomas World J Gastrointest Oncol Minireviews Cholangiocarcinoma and pancreatic cancer are the most common causes of malignant biliary obstruction. The majority of patients are diagnosed at a late stage when surgical resection is rarely possible. In these cases, palliative chemotherapy and radiotherapy provide only limited benefit and are associated with poor survival. Radiofrequency ablation (RFA) is a procedure for locoregional control of tumours, whereby a high-frequency alternating current turned into thermal energy causes coagulative necrosis of the tissue surrounding the catheter. The subsequent release of debris and tumour antigens by necrotic cells can stimulate local and systemic immunity. The development of endoluminal RFA catheters has led to the emergence of endoscopically delivered RFA, a treatment mainly used for malignant biliary strictures to prolong survival and/or stent patency. Other indications include recanalisation of occluded biliary stents and treatment of intraductal ampullary adenoma or benign biliary strictures. This article presents a comprehensive review of endobiliary RFA, mainly focusing on its use in patients with malignant biliary obstruction. The available data suggest that biliary RFA may be a promising modality, having positive impacts on survival and stent patency and boasting a reasonable safety profile. However, further studies with better characterised and stratified patient populations are needed before the method becomes accepted within routine clinical practice. Baishideng Publishing Group Inc 2021-10-15 2021-10-15 /pmc/articles/PMC8529920/ /pubmed/34721772 http://dx.doi.org/10.4251/wjgo.v13.i10.1383 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Minireviews Jarosova, Jana Macinga, Peter Hujova, Alzbeta Kral, Jan Urban, Ondrej Spicak, Julius Hucl, Tomas Endoscopic radiofrequency ablation for malignant biliary obstruction |
title | Endoscopic radiofrequency ablation for malignant biliary obstruction |
title_full | Endoscopic radiofrequency ablation for malignant biliary obstruction |
title_fullStr | Endoscopic radiofrequency ablation for malignant biliary obstruction |
title_full_unstemmed | Endoscopic radiofrequency ablation for malignant biliary obstruction |
title_short | Endoscopic radiofrequency ablation for malignant biliary obstruction |
title_sort | endoscopic radiofrequency ablation for malignant biliary obstruction |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529920/ https://www.ncbi.nlm.nih.gov/pubmed/34721772 http://dx.doi.org/10.4251/wjgo.v13.i10.1383 |
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