In recent years, intraductal ablation technologies have emerged as an adjunct for unresectable pancreatic and biliary malignancies and also for treating ingrowth of metallic stents. Radiofrequency ablation (RFA), photodynamic therapy (PDT), and argon plasma coagulation (APC) are all existing technologies that have been adapted for the use within the biliary tree. Only radiofrequency ablation is FDA approved for use within the biliary tree; both PDT and APC are considered off-label uses. These technologies are safe overall and relatively easy for the experienced biliary endoscopist to use. When considering any of these therapies, a multidisciplinary approach with buy-in from all disciplines involved in the care of the patient is crucial to good outcomes and managing any adverse events that may occur.
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RFA treatment of an occluded uncovered metal biliary stent in a patient with unresectable pancreatic cancer (MP4 289422 kb)
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