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Clinical Info

Biliary

Endobilliary Radiofrequency Ablation

Endobiliary Radiofrequency ablation (RFA) is a safe treatment for thin bile duct wall. It can be used with endoscopic or percutaneous approach to place a needle into a cholangiocarcinoma or benign stricture. In RFA, high-frequency electrical currents are passed through an electrode in the needle, creating a small region of heat. The heat destroys the tumor cells.

Learn more about Kidney RFA products

VIVA combo RF System

The VIVA combo RF System is compact and easy-to-use. Endoscopic radiofrequency (RF) ablation appears to be an effective tool for treating based on monopolar and bipolar RF ablation with temperature and continuance modes by VIVA combo RF system.

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ELRA Electrode

ELRA electrode is designed to operate at an efficient energy level and are activated that is introduced into the area where it is used to hear and ablation tissue. ELRA for the electronic surgical unit is used by connecting with RF lesion generator from STARmed Co. Ltd., which was designed to coagulate necrosis of tumor through local tissue heating. ELRA shows more flexibility to place the electrode at the exact site according to ablation plan, resulting as a standard to strive toward ablation zone.

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Clinical usefulness of EB-RFA

There are some reports showed the clinical usefulness of EB-RFA (Endobiliary-RFA), Most of them were small number retrsopecitve case series, they showed that EB-RFA may be safe and feasible treatment modality.
However, one thing to keep in mind is concern about procedure related morbidity and mortality.

Author Steel Tal Figueroa-Barajas Dolak Alis
Year 2011 2013 2013 2014 2013
# 22 12 20 58 17
Tumor site Pancreatic cancer 16
CCa 6		 Hilar CCa (B-IV) 9
Others 3		 CCa 11
Pancreatic cancer 7
Other 2		 Hilar CCa. 45
Others 13		 CCa (lesion unspecified)
Technical success, no.(%) 21 (95.5%) 12 (100%) 20 (100%) 58 (100%) 10 (58.8%)
Stent Uncovered SEMS 21 Plastic stent 12 Uncovered SEMS 1
Partially/fully covered SEMS 13
Plastic stent 6		 SEMS a 3
Plastic stent 19
No stent 4		 Fully covered SEMS 10
Median stent patency (d) 114 - - 171 270
Median survival (m) - 6.4 - 10.6 -
Median no. of RFA sessions 2 1.5 - 1.4 3
Complications no. (%) 4/21 (19%)
Cholecystitis 2
Pancreatitis 1
Rigor 1		 6/12 (50%)
Hemobilia 3 (Mortality: 2)		 5/20 (25%)
Pancreatitis 1
Cholecystitis 1
Pain: 5		 11/58 (19%)
Partial liver infarct 1
Hemobilia 3
GB empyema 1
Cholangitis 5
Sepsis 2
Hepatic coma 1
LBBB 1		 3/10 (30%)
Pancreatitis: 2
Author Strand Sharaiha Kallis Kallis Sharaiha Laquiere
Year 2014 2014 2015 2015 2015
# 16 26 23 69 12
Tumor site CCa (hilar 13) CCa 18
Pancreatic cancer 8		 Unresectable pancreatic cancer CCa 45
Pancreatic cancer 19
GB cancer 2
Other 4		 12 CCa
(Hilar CCa. B-I 4, B-II 3, B-III 2, B-IV 3)
Technical success, no.(%) 10 (100%) 26 (100%) 23 (100%) 69 (100%) 12 (100%)
Stent Plastic stent 15
Fully covered SMES 5
Uncovered SEMS 2		 Uncovered SEMS 7
Covered SEMS 8
Plastic stent 11		 Uncovered SEMS 23 SEMS 49
Plastic stent 20		 SEMS or plastic stent
Median stent patency (d) - - 324 - -
Median survival (m) 9.6 5.9 7.5 11.5 12.3
Median no. of RFA sessions 1.19 - - 1.4 1.63 (1-3)
Complications no. (%) - 5/26 (19.2%)
Pancreatitis 1
Cholangitis 1		 2/23 (8.7%)
Hyperamylasemia 1
Cholangitis 1		 7/69 (10.1%)
PEP 1
Cholecystitis 2
Hemobilia 2
Mild abdominal pain 3		 2/12 (16.7%)
Sepsis: 1
Cholangitis: 1
Author Laleman Yang
Year 2017 2018
# 18 65
Tumor site Pancreatic cancer 7
Distal CCa 2
Hilar CCa 9
(Hilar CCa. B-III 6, B-IV 3)		 Distal CCA 46
Bismuth I, II 19
Technical success, no.(%) - 65 (100%)
N=32( RFA+stent)
N=33 (stent)
Stent Distal : fully
covered SEMS
Hilar: plastic or
uncovered SEMS		 8.5 fr plastic stent
Median stent
patency (d)		 110 days
- Distal 187
- Hilar 139		 6.5 months
3.4 months
Median
survival (m)		 7.6 13.2 ± 0.6
8.3 ± 0.5
Median no. of RFA sessions 1 -
Complications no. (%) 6/18 (30%)
Mild cholangitis 4
Mild PEP 2		 5/65 (7.6%)
Cholangitis 3
Pancreatitis 1
Hemorrhage 1

Reference

Percutaneous Radiofrequency Ablation of Sporadic Bosniak III or IV Lesions: Treatment Techniques and Short-Term Outcomes Journal of Vascular and Interventional Radiology 2015 Jung Jae Park
CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes KJR 2016 Hae Jin Kim, MD
Anesthetic management for percutaneous computed tomography-guided radiofrequency ablation of reninoma KJR 2015 Nam-Su Gil
Efficacy and safety of ultrasound-guided radiofrequency ablation of hyperplastic parathyroid gland for secondary hyperparathyroidism associated with chronic kidney disease head&neck 2016 Chengzhong Peng, MS