Endobiliary radiofrequency ablation for distal extrahepatic cholangiocarcinoma: A clinicopathological study

• Published in: PloS one 2018-11, Vol.13 (11), p.e0206694-e0206694
• Main Authors: Kim, Eui Joo, Chung, Dong Hae, Kim, Yoon Jae, Kim, Yeon Suk, Park, Yeon Ho, Kim, Keon Kuk, Cho, Jae Hee
• Format: Article
• Language: English
• Subjects: Ablation; Aged; Bile; Bile Duct Neoplasms - diagnostic imaging; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - therapy; Bile Ducts, Extrahepatic - diagnostic imaging; Bile Ducts, Extrahepatic - pathology; Biology and Life Sciences; Cancer; Catheters; Cholangiocarcinoma; Cholangiocarcinoma - diagnostic imaging; Cholangiocarcinoma - pathology; Cholangiocarcinoma - therapy; Cholangitis; Cholestasis, Extrahepatic - diagnostic imaging; Cholestasis, Extrahepatic - etiology; Cholestasis, Extrahepatic - pathology; Cholestasis, Extrahepatic - therapy; Complications; Decompression; Endoscopy; Engineering and Technology; Feasibility Studies; Female; Fluoroscopy; Gastroenterology; Health care facilities; Histology; Humans; Internal medicine; Jaundice; Liver Neoplasms - secondary; Male; Medical imaging; Medical prognosis; Medical records; Medicine; Medicine and Health Sciences; Metastases; Middle Aged; Necrosis; Pancreatic cancer; Patients; Perforation; Peritonitis; Photodynamic therapy; Radio frequency; Radiofrequency Ablation; Retrospective Studies; Studies; Surgery; Tomography; Treatment Outcome; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0206694

Most patients with distal extrahepatic cholangiocarcinoma have developed jaundice or cholangitis at the time of initial diagnosis, which can delay surgery. We aim to evaluate the actual EB-RFA ablation volume and validated the clinical feasibility of preoperative endobiliary radiofrequency ablation (EB-RFA) for resectable distal extrahepatic cholangiocarcinoma. The medical records of patients who underwent EB-RFA from July 2016 to June 2017 at a single tertiary academic medical center were reviewed. Inclusion criteria were patients with resectable distal extrahepatic cholangiocarcinoma who required preoperative biliary decompression. Clinical outcomes of EB-RFA were reviewed retrospectively and the surgical specimens were reevaluated. Of the eight patients who required a delayed operation, preoperative EB-RFA was successfully performed without serious complications including peritonitis, hemobilia, or perforation. Although curative resection was attempted in all patients, one patient underwent open and closure due to hepatic metastasis. Seven patients underwent curative surgical resection and the histology revealed that median maximal ablation depth was 4.0 mm (range, 1-6) and median effective ablation length (histological ablation length/fluorosocopic ablation length) was 72.0% (range, 42.1-95.3). EB-RFA partially ablated human cancer tissue and preoperative EB-RFA might be a safe and feasible in patients with distal extrahepatic cholangiocarcinoma who require a delayed operation. Ablation of the target lesion longer than the estimated length by fluoroscopy may improve the efficacy of EB-RFA.