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Radiofrequency ablation for biliary malignancies management: An emerging therapeutic option – Review

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ABSTRACT
The malignancies of the bile duct are often diagnosed in advanced stage, when the biliary obstruction is already present. The palliative treatment for the biliary decompression may improve the patient’s survival and his quality of life. Several palliative treatments are possible, such as stent placing and radiofrequency ablation (RFA), both being used by either percutaneous or endoscopic approach. This review focuses on the feasibility, safety and clinical efficacy of endoscopic-guided
biliary RFA in the biliary malignancies. Currently, biliary stenting (plastic or metallic biliary stents) is the standard of care for palliative drainage procedures, but there are several studies evaluating the use of RFA in the bilio-pancreatic malignant diseases. There are studies that confirmed that RFA prior to biliary stenting might be more effective than stenting alone. At this moment, available data suggest that endoscopic RFA represents a feasible treatment option, with an acceptable safety profile and with a favorable impact on early survival on patients with malignancies of the bile duct, but prospective randomized controlled trials are needed in order to accurately assess the efficacy in terms of survival and quality of life.

Key words: biliary malignancy, palliative biliary drainage, radiofrequency ablation.

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Vasile Sandru, Bogdan Silviu Ungureanu, Dan Ionut Gheonea, Madalina Ilie, Irina - Gabriela Diaconu and Gabriel Constantinescu

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