Radiofrequency Ablation for Benign Biliary Strictures: Mechanisms, Techniques, and Clinical Applications

Document Type

Conference Proceeding

Publication Date

11-12-2025

Publication Title

Cardiovasc Intervent Radiol

Keywords

balloon dilatation, Berg Balance Scale, bile duct, biliary cannulation, biliary cirrhosis, biliary drain, biliary tract drainage, catheterization, cholangiography, cholangitis, cholestasis, chronic pancreatitis, complication, conference abstract, controlled study, drainage tube, endoscopic retrograde cholangiopancreatography, guide wire, human, jaundice, postoperative complication, quality of life, radiofrequency ablation, reoperation, surgery, therapy, thermal ablation, tube removal

Abstract

Learning objectives: Describe indications for radiofrequency ablation (RFA) in benign biliary strictures (BBS). Explain procedural steps/techniques of RFA in managing BBS. Identify future applications and implications of RFA in BBS management. Background: Patients with BBS present with cholestatic enzyme abnormalities, jaundice, recurrent ascending cholangitis can progress to biliary cirrhosis and infection risk.l Etiologies include iatrogenic injuries, surgical complications, chronic pancreatitis, and primary sclerosing cholangitis.1 Current conventional treatment is Endoscopie Retrograde Cholangiopancreatography (ERCP) with balloon dilation and stenting. However, refractory cases require surgical revision, necessitating additional interventions at a 17% failure rate.2 Alternatively, long-term percutaneous biliary catheterization, while effective, significantly decreases quality of life due to prolonged drainage tube placement.3 Endobiliary RFA recently emerged as an alternative, utilizing thermal ablation to remodel fibrotic strictures, potentially enabling earlier drainage tube removal and lower recurrence rates.4 However, current literature predominantly supports RFA for malignant strictures, with limited use in benign diseases. Clinical findings/procedure details: A needle is used under imaging guidance to access the bile duct via a percutaneous transhepatic approach, followed by cholangiography to assess stricture anatomy and morphology.5 A guidewire crosses the stricture and is dilated for RFA catheter insertion, ablating the fibrotic tissue.5 Next, an internal-external biliary drain or stent maintains bile drainage and healing, potentially allowing early removal.5 Conclusion: RFA presents a less invasive alternative to surgery and ERCP for recurrent BBS, offering promising outcomes.6 Further research with larger patient cohorts is needed to establish long-term patency.

Volume

48

Issue

4

First Page

S593

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