Endobiliary Radiofrequency Ablation for Hepato-Biliary Diseases: A Narrative Review

Background/Objectives: Malignant biliary diseases still represent a therapeutic challenge given its poor prognosis, and limited response to the available curative treatments. Recently, endobiliary radiofrequency ablation (RFA) has been increasingly reported as an adjunct therapeutic option for biliary diseases, especially malignant biliary obstruction (MBO), due to potentially improving survival and stent patency. Methods: Herein, we provide a comprehensive review article discussing the indication, procedural details, safety, and comparative efficacy of endobiliary RFA to aid in providing an in-depth understanding of the clinical indications and future implications of this specific option. Results: Overall, endobiliary RFA is technically feasible, being associated with a high safety profile, significantly improving biliary stent patency, and having a potential benefit in extending the survival of patients with MBO who were treated with endobiliary RFA combined with biliary stenting vs. stenting alone. Moreover, it has a promising role in the treatment of intraductal extension of ampullary tumors. Conclusions: Endobiliary RFA had a beneficial therapeutic effect in biliary strictures, with potential impact on patients outcome and survival.