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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...

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Autores principales: Jarosova, Jana, Macinga, Peter, Hujova, Alzbeta, Kral, Jan, Urban, Ondrej, Spicak, Julius, Hucl, Tomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
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.
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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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