Intraductal radiofrequency ablation under direct vision of choledochoscopy for the treatment of malignant common hepatic duct stricture

Abstract

Novel intraductal radiofrequency ablation for malignant biliary stricture indicated good therapeutic prospect. In traditional intraductal radiofrequency ablation, the radiofrequency catheter was placed through endoscopic retrograde cholangiography or percutaneous transhepatic cholangiogram under the supervision of X-ray. In February 2014, a patient with intrahepatic adenocarcinoma of the bile duct and malignant common hepatic duct stricture was admitted to the Shenzhen People′s Hospital. The patient received cholecystectomy + choledocholithotomy + T tube drainage 3 months prior to the admission. The results of histopathological examination indicated reactive hyperplasia. The patient recovered uneventfully after the operation. One week before the admission, the patient had jaundice and umber urine and received choledochoscopy + common bile duct dilatation + histopathological examination + biliary stent placement. The results of pathological examination confirmed that the patient had intrahepatic adenocarcinoma of the bile duct. The patient received intraductal radiofrequency ablation through T-tube fistula under direct vision of choledochoscopy, and recovered well after the operation. Intraductal radiofrequency ablation under direct vision of choledochoscopy not only has the advantages of accurate positioning and real-time monitoring, but also facilitate cyclical repeat treatment. Key words: Malignant biliary stricture; Radiofre-quency ablation; Choledochoscopy