Endoscopy 2017; 49(10): 977-982
DOI: 10.1055/s-0043-113559
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A new intraductal radiofrequency ablation device for inoperable biliopancreatic tumors complicated by obstructive jaundice: the IGNITE-1 study

Wim Laleman
Department of Gastroenterology & Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Schalk van der Merwe
Department of Gastroenterology & Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Len Verbeke
Department of Gastroenterology & Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Dirk Vanbeckevoort
Department of Radiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Raymond Aerts
Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Hans Prenen
Department of Gastroenterology & Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Eric Van Cutsem
Department of Gastroenterology & Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
,
Chris Verslype
Department of Gastroenterology & Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
› Author Affiliations
Further Information

Publication History

submitted 17 January 2017

accepted after revision 09 May 2017

Publication Date:
21 July 2017 (eFirst)

Abstract

Background and study aims Biliary stenting of unresectable malignant bile duct obstruction is generally accepted as the standard of care but it can be hampered by tumor ingrowth and stent dysfunction. We aimed to test the feasibility, safety, and biliary patency rate of a new endoscopically applied intraductal radiofrequency ablation (RFA) device.

Patients and methods Eighteen patients with inoperable malignant biliary obstruction underwent endoscopic retrograde cholangiopancreatography (ERCP)-directed RFA and stenting.

Results Between December 2014 and November 2015, 18 patients underwent RFA to the intended region, with no complications within 3 months of the procedure. Bilirubin levels post-RFA and stenting decreased significantly (7.8 ± 1 mg/dL to 1.7 ± 0.4 mg/dL; P < 0.001). At 90 and 180 days post-intervention, biliary patency was maintained in 80 % and 69 % of patients still alive at that time, respectively. The median overall stent patency was 110 days (range 16 – 374), with a median patient survival of 227 days (range 16 – 374).

Conclusion Intraductal RFA using a new device in patients with inoperable biliopancreatic cancer complicated by jaundice appeared feasible and safe with acceptable biliary patency. Randomized trials with prolonged follow-up are warranted.

ClinTrials.gov: NCT02468076.