Healthcare professionals / Gastroenterology / HabibTM EndoHPB Bipolar Radiofrequency Catheter / Ampullary Neoplasm
  

Intraductal Adenoma

Clinical Challenge
  • Endobiliary dysplasia may persist in 30%, post papillectomy1
  • Surgery has been standard management consideration,radiofrequency ablation may offer an additional treatment option

Clinical Goal

Management of ductal dysplasia post papillectomy

Literature Highlights

Prospective, multi-center study has shown1

  • Residual neoplasia at 6mo and 12 mo. of 15% and 30%
  • No major adverse events
    • 15% mild pancreatitis
    • 5% cholangitis
    • 10% mild biliary stricture
  • Another study6showed mean number of ablations sessions of 1 per patient (range 1-5). Those with high-grade dysplasiareceived a mean of 2.6 + 1.5 (p=0.011)

ESGE RECOMMENDATION

ESGE suggests the use, in expert centers, of complementary techniques (thermal ablation by cystotome, or radiofrequency ablation [RFA]) with temporary biliary stenting, for ampullary adenoma with ≤20-mm intraductal extension.

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  1. Sharaiha, R et al, Comparison of Metal Stenting with Radiofrequency Ablation Versus Stenting Alone for Treating Malignant Biliary Strictures: Is There an Added Benefit?, Dig Dis Sci, June 2014
  2. Yang, Efficacy and safety of endoscopic radiofrequency ablation for unresectable extrahepatic cholangiocarcinoma: a randomized trial,  Endoscopy 2018
  3. Liang et al., metal Stenting with or w/o Endobiliary RFA for Unresectable Extrahepatic Cholangiocarcinoma, Journal of Cancer Therapy, 2015, 6, 981-982
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