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  • Clinical Indication
  • Billiary Tract Radiofrequency Ablation

Biliary Radiofrequency ablation (RFA) is a safe treatment for thin bile duct wall. It can be used with endoscopic or percutaneous approach to place a needle into a cholangiocarcinoma or benign stricture. In RFA, high-frequency electrical currents are passed through an electrode in the needle, creating a small region of heat. The heat destroys the tumor cells.

Learn more about Biliary RFA products

VIVA combo RF System
The VIVA combo RF System is compact and easy-to-use. Endoscopic radiofrequency (RF) ablation appears to be an effective tool for treating based on monopolar and bipolar RF ablation with temperature and continuance modes by VIVA combo RF system.
ELRA Electrode
ELRA electrode is designed to operate at an efficient energy level and are activated that is introduced into the area where it is used to hear and ablation tissue.
ELRA for the electronic surgical unit is used by connecting with RF lesion generator from STARmed Co. Ltd., which was designed to coagulate necrosis of tumor through local tissue heating.
ELRA shows more flexibility to place the electrode at the exact site according to ablation plan, resulting as a standard to strive toward ablation zone.
  • Clinical usefulness of EB-RFA

There are some reports showed the clinical usefulness of EB-RFA (Endobiliary-RFA),
Most of them were small number retrsopecitve case series, they showed that EB-RFA may be safe and feasible treatment modalty.
However, one thing to keep in mind is concern
about procedure related morbidity and mortality.

#1

Author Steel Tal Figueroa-Barajas Dolak Alis
Year 2011 2013 2013 2014 2013
# 22 12 20 58 17
Tumor site Pancreatic cancer 16
CCa 6
Hilar CCa (B-IV) 9
Others 3
CCa 11
Pancreatic cancer 7
Other 2
Hilar CCa. 45
Others 13
CCa (lesion unspecified)
Technical success, no.(%) 21 (95.5%) 12 (100%) 20 (100%) 58 (100%) 10 (58.8%)
Stent Uncovered SEMS 21 Plastic stent 12 Uncovered SEMS 1
Partially/fully covered SEMS 13
Plastic stent 6
SEMS a 3
Plastic stent 19
No stent 4
Fully covered SEMS 10
Median stent
patency (d)
114 - - 171 270
Median
survival (m)
- 6.4 - 10.6 -
Median no. of RFA sessions 2 1.5 - 1.4 3
Complications no. (%) 4/21 (19%)
Cholecystitis 2
Pancreatitis 1
Rigor 1
6/12 (50%)
Hemobilia 3 (Mortality: 2)
5/20 (25%)
Pancreatitis 1
Cholecystitis 1
Pain: 5
11/58 (19%)
Partial liver infarct 1
Hemobilia 3
GB empyema 1
Cholangitis 5
Sepsis 2
Hepatic coma 1
LBBB 1
3/10 (30%)
Pancreatitis: 2

#2

Author Strand Sharaiha Kallis Kallis Sharaiha Laquiere
Year 2014 2014 2015 2015 2015
# 16 26 23 69 12
Tumor site CCa (hilar 13) CCa 18
Pancreatic cancer 8
Unresectable pancreatic cancer CCa 45
Pancreatic cancer 19
GB cancer 2
Other 4
12 CCa
(Hilar CCa. B-I 4, B-II 3, B-III 2, B-IV 3)
Technical success, no.(%) 10 (100%) 26 (100%) 23 (100%) 69 (100%) 12 (100%)
Stent Plastic stent 15
Fully covered SMES 5
Uncovered SEMS 2
Uncovered SEMS 7
Covered SEMS 8
Plastic stent 11
Uncovered SEMS 23 SEMS 49
Plastic stent 20
SEMS or plastic stent
Median stent
patency (d)
- - 324 - -
Median
survival (m)
9.6 5.9 7.5 11.5 12.3
Median no. of RFA sessions 1.19 - - 1.4 1.63 (1-3)
Complications no. (%) - 5/26 (19.2%)
Pancreatitis 1
Cholangitis 1
2/23 (8.7%)
Hyperamylasemia 1
Cholangitis 1
7/69 (10.1%)
PEP 1
Cholecystitis 2
Hemobilia 2
Mild abdominal pain 3
2/12 (16.7%)
Sepsis: 1
Cholangitis: 1

#3

Author Laleman Yang
Year 2017 2018
# 18 65
Tumor site Pancreatic cancer 7
Distal CCa 2
Hilar CCa 9
(Hilar CCa. B-III 6, B-IV 3)
Distal CCA 46
Bismuth I, II 19
Technical success, no.(%) - 65 (100%)
N=32( RFA+stent)
N=33 (stent)
Stent Distal : fully
covered SEMS
Hilar: plastic or
uncovered SEMS
8.5 fr plastic stent
Median stent
patency (d)
110 days
- Distal 187
- Hilar 139
6.5 months
3.4 months
Median
survival (m)
7.6 13.2 ± 0.6
8.3 ± 0.5
Median no. of RFA sessions 1 -
Complications no. (%) 6/18 (30%)
Mild cholangitis 4
Mild PEP 2
5/65 (7.6%)
Cholangitis 3
Pancreatitis 1
Hemorrhage 1

Reference

Endoscopic stent placement combined with tumor ablation therapy Gastrointest Interv 2015 Rajech Gupta
Utilisation de la radiofréquence en endoscopie digestive POST’U 2017 Geoffroy Vanbiervliet
A new intraductal radiofrequency ablation device for inoperable biliopancreatic tumors complicated by obstructive jaundice: the IGNITE-1 study Endoscopy 2017 Wim Laleman
Safety and Efficacy of Endobiliary Radiofrequency Ablation by Using a Novel RF Catheter (ELRA®) in Patients With Distal Malignant Biliary Strictures: A Single-Arm Feasibility Study GIE 2017 Jong Ho Moon
Comparison of two porcine benign esophageal stricture models using radiofrequency ablation and endoscopic submucosal tunnel dissection Turk J Gastroenterol 2018 Byoung Bang Wook
Efficacy of Endobiliary Radiofrequency Ablation using a Novel Endoluminal Radiofrequency Ablation Catheter in a Swine Model Journal of Investigative surgery 2018 Hyun-Ho Choi
Endobiliary radiofrequency ablation for distal extrahepatic cholangiocarcinoma: A clinicopathological study PLOS One 2018 Eui Joo Kim