Purpose of review: Intraductal biliary radiofrequency ablation (RFA) is an emerging therapeutic modality that directly targets malignant biliary strictures during endoscopic retrograde cholangiopancreatography. This article reviews the technology, endoscopic technique, and reported outcomes of endoscopic RFA in the management of malignant biliary strictures.
Recent findings: Biliary RFA is feasible and has a high technical success rate. Infectious complications and major hemobilia are the main adverse events requiring intervention. It is unclear whether RFA prolongs biliary stent patency or decreases the need for repeated endoscopic interventions. Retrospective studies suggest a possible survival benefit with RFA.
Summary: Intraductal biliary RFA is a promising modality for management of malignant biliary obstruction. Prospective randomized studies are required to determine whether RFA truly confers a survival benefit or decreases the number of biliary interventions.