Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
Gastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania.
Dig Endosc. 2019 May;31(3):245-255. doi: 10.1111/den.13298. Epub 2019 Jan 4.
Radiofrequency ablation (RFA) functions by delivering thermal energy within tissue, the result of a high-frequency alternating current released from an active electrode, leading to coagulative necrosis and cellular death. Recently, a biliary catheter working on a guidewire has been developed and a number of studies have so far been carried out. The present article provides a comprehensive review of the literature on the results of the use of RFA for the clinical management of patients with unresectable malignant biliary strictures, benign biliary strictures, and residual adenomatous tissue in the bile duct after endoscopic papillectomy. Available data show that biliary RFA treatment is a promising adjuvant therapy in patients with unresectable malignant biliary obstruction. The procedure is safe, well tolerated and improves stent patency and survival, even though more studies are warranted. In patients with residual endobiliary adenomatous tissue after endoscopic papillectomy, a significant rate of neoplasia eradication after a single RFA session has been reported, thus favoring this treatment over surgical intervention. In these patients, as well as in those with benign biliary strictures, dedicated probes with a short electrode able to focus the RF current on the short stenosis are needed to expand RFA treatment for these indications.
射频消融（RFA）通过在组织内传递热能来发挥作用，这是一种从活动电极释放的高频交流电的结果，导致凝固性坏死和细胞死亡。最近，已经开发出一种在导丝上工作的胆道导管，并进行了多项研究。本文对射频消融在不可切除的恶性胆道狭窄、良性胆道狭窄和内镜乳头切开术后胆管内残留腺瘤组织的临床管理中的应用结果的文献进行了全面回顾。现有数据表明，胆道 RFA 治疗是不可切除的恶性胆道梗阻患者的一种有前途的辅助治疗方法。该手术安全、耐受良好，可改善支架通畅性和生存率，尽管还需要更多的研究。在经内镜乳头切开术切除胆管内残留的腺瘤组织后，单次 RFA 治疗后肿瘤消除率较高，因此支持这种治疗方法而不是手术干预。对于这些患者以及良性胆道狭窄患者，需要使用带有短电极的专用探头，以便将 RF 电流聚焦在短狭窄部位，从而扩大 RFA 治疗这些适应症的范围。
