Karagiannakis DS. Percutaneous transhepatic cholangiography: An effective option for endo-biliary radiofrequency ablation before stent insertion in unresectable biliary cancer? World J Clin Cases 2024; 12(30): 6413-6416 [DOI: 10.12998/wjcc.v12.i30.6413]
Corresponding Author of This Article
Dimitrios S Karagiannakis, MD, PhD, Academic Research, Lecturer, Academic Department of Gastroenterology, Medical School of the National and Kapodistrian University of Athens, "Laiko" General Hospital, Aghiou Thoma 17, Athens, Greece, Athens 11527, Greece. dkarag@med.uoa.gr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2024; 12(30): 6413-6416 Published online Oct 26, 2024. doi: 10.12998/wjcc.v12.i30.6413
Percutaneous transhepatic cholangiography: An effective option for endo-biliary radiofrequency ablation before stent insertion in unresectable biliary cancer?
Dimitrios S Karagiannakis
Dimitrios S Karagiannakis, Academic Department of Gastroenterology, Medical School of the National and Kapodistrian University of Athens, "Laiko" General Hospital, Athens 11527, Greece
Author contributions: Karagiannakis DS contributed to writing, review, and editing, writing original draft, supervision, resources, methodology, investigation, formal analysis, data curation, and conceptualization.
Conflict-of-interest statement: There is no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios S Karagiannakis, MD, PhD, Academic Research, Lecturer, Academic Department of Gastroenterology, Medical School of the National and Kapodistrian University of Athens, "Laiko" General Hospital, Aghiou Thoma 17, Athens, Greece, Athens 11527, Greece. dkarag@med.uoa.gr
Received: May 18, 2024 Revised: August 19, 2024 Accepted: August 27, 2024 Published online: October 26, 2024 Processing time: 108 Days and 23.3 Hours
Abstract
Biliary cancer is a highly aggressive disease that is typically diagnosed at advanced stages when surgical removal is no longer an option. In these cases, palliative care and mechanical widening of the blocked biliary system are preferred. The insertion of a stent is often necessary to prevent the recurrence of blockages caused by cancer progression. Prior to stent placement, endo-biliary radiofrequency ablation (EB-RFA) appears to result in longer-lasting stent effectiveness without increasing the risk of severe complications. However, its impact on overall survival is not yet clear. Additionally, while endoscopic retrograde cholangiopancreatography is the most common method for performing EB-RFA, percutaneous transhepatic cholangiodrainage seems to be a safe and potentially more efficient alternative, particularly for long, angulated, or significantly narrowed bile ducts.
Core Tip: Ablate or not prior to stent insertion in patients with unresectable biliary cancer? The role of endo-biliary radiofrequency ablation before stent remains unclear regarding the overall survival and the prolongation of stent patency. Contrary results are probably attributed to differences in the studies' design, cancer extensiveness, patient performance status, and applied technique. Moreover, it has to be clarified whether percutaneous transhepatic cholangiodrainage overcomes endoscopic retrograde cholangiopancreatography as the method of choice for performing ablation, especially in more complicated cases.
