Background and study aim: Obstruction of biliary self-expandable metal stents (SEMSs) is seen frequently. Radiofrequency
ablation (RFA) causes tissue necrosis. This study aimed to assess the efficacy of
RFA for management of occluded SEMS.
Patients and methods: Patients with biliary malignancy and treated for an occluded SEMS were retrospectively
reviewed. The study group comprised patients treated with RFA using an Habib endoprobe
inside the SEMS. The control group comprised patients treated only with insertion
of a plastic stent into an occluded SEMS. The end points were; 90-day stent patency
rate, time to stent reocclusion, 30-day mortality, and 3 – and 6-month survival rates.
Results: During the 5-year study period 25 patients with an occluded SEMS underwent RFA and
25 patients underwent a plastic stent placement only. Both groups were matched for
age and diagnosis. Immediate biliary drainage was restored in all patients. In the
RFA group, the stenosis was ablated successfully in 14 patients (56 %); ablation failed
in 11 and a plastic stent was then inserted into the SEMS for these. The control group
had only placement of a plastic stent across the stenosis. Stent patency rate at 90
days was 56 % and 24 % in the RFA and control groups, respectively (P = 0.04). The mean stent patency time was significantly longer in the RFA group compared
to the control group (119.5 vs. 65.3 days, P = 0.03).
Conclusion: The application of RFA for occluded SEMS improves stent patency. RFA is an alternative
treatment of tissue ingrowth in malignant biliary obstruction.