Efficacy of Endobiliary Radiofrequency Ablation for Malignant Biliary Obstruction

Malignant biliary tract obstruction (MBTO) is caused by a group of neoplasms that compromise bile duct flow, and the clinical presentation includes obstructive jaundice. The optimal treatment depends on both the type of malignancy and the stage of disease. Surgical resection may be the first choice of treatment. However, an operation is often impossible because of locally advanced disease or a high metastatic potential at the time of diagnosis. Considering the unfavorable prognosis of unresectable MBTO, endobili-ary radiofrequency ablation (EB-RFA) has emerged as a palliative therapeutic modality that directly ablates malignant tissue in the bile duct. To date, some reports have suggested that EB-RFA is possibly beneficial, but it remains unclear whether EB-RFA prolongs biliary stent patency or overall survival. Nevertheless, EB-RFA is regarded as a promising loco-regional therapy for MBTO. This review focuses on the clinical application of the technique and its appropriate use, along with the benefits afforded and the complications encountered. (Korean J Med 2017;92:437-442)