Cholangiocarcinoma Clinical Trial
Official title:
Endoscopic Biliary Radiofrequency Ablation of Malignant Bile Duct Obstruction
Endoscopic radiofrequency ablation (RFA) is a new palliation therapy for malignant bile duct obstruction. It delivers a high amount of thermal energy to target tissue and may prolong the duration of stent patency. RFA has showed promising results for malignant bile duct obstruction and increasing the duration of stent patency. The aim of our study was to evaluate the feasibility and safety of endoscopic RFA for the treatment of bile duct obstructions, and to compare the efficacy of Endoscopic biliary RFA with the addition of self-expanding metal stents (SEMS) to SEMS alone in a randomized controlled trial.
Malignant bile duct obstructions are caused by many diseases arising from primary or
metastatic disease in intrahepatic, extrahepatic or hilar locations. To relieve obstructive
decompression and jaundice as a result of the obstruction, endoscopic stent placement is
usually required. Compared with surgical intervention, stent insertion offers shorter
hospitalization, lower overall cost and lower morbidity. Previous studies have shown the
superiority of SEMSs over plastic stents for maintaining biliary drainage. However, SEMS can
occlude due to epithelial hyperplasia, tumor in-/overgrowth, biofilm deposition and sludge
formation. Studies have showed that the median SEMS patency is 120 days. Once bile duct
obstruction reoccurs, it may lead to significant morbidity and mortality. Thus, long-term
patency of the SEMS remains an unresolved issue.
Recently, endoscopic biliary radiofrequency ablation (RFA) have been used in patients
suffering from inoperable malignant bile duct obstruction, and increasing the duration of
stent patency. It delivers a high amount of thermal energy to target tissue with curative or
palliative intent. The purpose of this study is to record information and evaluate the
impact of radiofrequency ablation in improving the management of cholangiocarcinoma or
malignant bile duct obstruction, and to compare the effects of SEMS plus RFA to SEMS alone.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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