Endobiliary radiofrequency ablation for refractory benign stricture: a PILOT BICENTRIC STUDY

Introduction: Endoscopic treatment of benign biliary stricture (BBS) re- mains challenging with 15% of recurrence ater metallic or multiple plastic stenting. We experimented endobiliary radiofrequency ablation (ERFA) with the aim to eradicate biliary fibroplasia endoscopically. We report our first experience of ERFA in the management of refractory BBS. aims & Methods: 8 patients with BBS (5 postoperative strictures, 2 chronic inflammatory strictures and 1 post stenting stricture) were treated from august 2014 to march 2018. All had previously unsuccessful endoscopic treatment with dilatations (1,75 [0-3]) and plastic or metallic stenting dur- ing a median of 18 months (9-48). Bipolar ERFA was delivered at power of 10 W for 90 seconds per stricture segment, followed by a 10 mm balloon dilatation without stent placement. Data were collected on technical suc- cess (ERFA delivery), clinical success (stricture resolution), adverse events and follow-up. results: ERFA was performed in 8 patients (7 men) with a median age of 56 years (range 20-81). All patients had stricture resolution after ERFA. No severe adverse event occurred with only a case of short abdominal mild pain. The median follow-up is 31 months. BBS resolution without the need for further stenting was achieved in 6 patients. The 2 patients with inflammatory stricture had BBS relapse after initial resolution at 10 and 12 months, one underwent surgery, the other metallic stenting for 9 months with no further relapse at 2 years. Wednesday, October 23, 2019 Tuesday, October 22, 2019 Monday, October 21, 2019 274 UEG Journal | Abstract Book conclusion: ERFA appears to be a safe and effective treatment for refractory BBS, especially for postoperative strictures. Further studies are warranted.