Radiofrequency Ablation Of Malignant Biliary Obstruction

Endoscopically applied radiofrequency ablation (RFA) of malignant biliary strictures has been introduced recently. An 84-year-old white female was referred for a presumed malignant common hepatic duct (CHD) stricture. She had previously undergone 5 ERCPs, with 3 negative brush cytology results. Cholangiography demonstrated a stricture at the CHD level with bilateral intrahepatic bile duct dilation. Cholangioscopy revealed a mass lesion at the CHD. A forceps biopsy was performed; biopsy specimens showed fragments of acutely inflamed biliary mucosa with rare atypical glands, thus raising the possibility of adenocarcinoma.