Biliary Radiofrequency Ablation and Sphincterotomy Restenosis: A Unique Case of Biliary Obstruction

Biliary radiofrequency ablation is an emerging adjunctive and palliative therapy for patients with ampullary and biliary tumors. Given the high mortality for these malignancies, data on long-term complications are limited. We report a unique case of sphincterotomy restenosis causing biliary obstruction in a 98-year-old woman with a history of ampullary adenocarcinoma treated with papillectomy and biliary radiofrequency ablation (RFA). Endoscopic retrograde cholangiopancreatography revealed restenosis at the sphincterotomy site, managed successfully with repeat sphincterotomy and stenting. This case highlights sphincterotomy restenosis as a potential late complication of biliary RFA and emphasizes the need for awareness of delayed biliary obstruction in post-RFA patients.