Inoue Tadahisa, Yoneda Masashi
Department of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Aichi, Japan.
World J Gastrointest Endosc. 2023 Jun 16;15(6):440-446. doi: 10.4253/wjge.v15.i6.440.
Recently, endoscopic intraductal radiofrequency ablation (ID-RFA) has attracted attention as a local treatment method for malignant biliary obstruction (MBO). ID-RFA causes coagulative necrosis of the tumor tissue in the stricture and induces exfoliation. Its effects are expected to extend the patency period of biliary stents and prolong the survival period. Evidence for extrahepatic cholangiocarcinoma (eCCA) is gradually accumulating, and some reports show significant therapeutic effects in eCCA patients without distant metastasis. However, it is still far from an established treatment technique, and many unsolved problems remain. Therefore, when performing ID-RFA in clinical practice, it is necessary to understand and grasp the current evidence well and to operate appropriately for the true benefit of the patients. This paper reviews the current status, issues, and prospects of endoscopic ID-RFA for MBO, especially for eCCA.
最近，内镜下导管内射频消融术（ID-RFA）作为恶性胆管梗阻（MBO）的一种局部治疗方法受到了关注。ID-RFA可导致狭窄部位肿瘤组织发生凝固性坏死并促使其脱落。其效果有望延长胆管支架的通畅期并延长生存期。肝外胆管癌（eCCA）的相关证据正在逐渐积累，一些报告显示，该方法对无远处转移的eCCA患者具有显著的治疗效果。然而，它仍远非一种成熟的治疗技术，仍存在许多未解决的问题。因此，在临床实践中进行ID-RFA时，有必要充分了解和掌握当前的证据，并为患者的真正利益进行适当操作。本文综述了内镜下ID-RFA治疗MBO，尤其是eCCA的现状、问题及前景。
