Radiofrequency Ablation (RFA) with Biliary Stenting in Malignant Biliary Obstruction: Single-Institution Experience

Background/Objectives: Endoscopic biliary stenting is the standard palliative intervention for malignant biliary obstruction, aimed at restoring ductal patency. Radiofrequency ablation (RFA) has been introduced as an adjunct technique to improve stent durability and patient outcomes. However, the literature remains inconclusive regarding which patients are most likely to benefit from the combination of RFA and stenting. Methods: To assess clinical outcomes of patients undergoing RFA with biliary stenting and identify the factors associated with treatment success, clinical data were collected from 24 patients suffering from non-resectable malignancies. Post-procedural and 6-month follow-up clinical success and complication rates were measured by the technical success of RFA and a decrease in blood bilirubin levels. Results: Nineteen females and five males were included in the study. The most prevalent diagnoses were metastatic adenocarcinoma (n = 8) and cholangiocarcinoma (n = 6). 25% of patients did not complete the 6-month follow-up due to malignancy progression. 16 out of 18 maintained the patency of biliary stents and were able to continue the oncological treatment. The two patients required multiple unsuccessful endoscopic interventions. Conclusions: RFA with biliary stenting is a very effective, safe method for maintaining biliary patency in cases of unresectable biliary malignant obstruction. While we did not identify any specific factors associated with treatment success or failure, our findings support the use of RFA with biliary stenting as a safe, feasible option in non-resectable malignancies of the biliary tract.