First experience of endoscopic radiofrequency ablation in the treatment of patients with mechanical jaundice in occlusion of metallic biliary stents

Objective. To evaluate the efficacy of endoscopic radiofrequency ablation (ERFA) in the treatment of mechanical jaundice with tumor occlusion of metallic self-expanding biliary stents (SES). Material and methods. In the period from January 2020 to December 2024, 822 biliary endoprostheses in patients with mechanical jaundice of tumor genesis were performed at the N.V. Sklifosovsky Research Institute of Emergency Medicine (497 (60.5%) patients were fitted with SES, 325 (39.5%) — with plastic stents). The study group included 12 (12.6%) patients hospitalized at the N.V. Sklifosovsky SP Research Institute from January 2020 to December 2024, in whom ERFA was used as a method of endoscopic treatment of occluded SES. Of these patients, 4 (33.3%) were men and 8 (66.7%) were women. The mean age of the patients was 68.5 (53; 89) years. Results. All 12 (100%) patients were indicated for ERFA. In 10 (83.4%) patients after ERFA procedure the postcoagulation scab was revisioned and extracted into the intestinal lumen using a lithoextraction balloon, and 2 (16.6%) patients had a nasobiliary drainage installed in addition. The average duration of interventions was 53 min. No intra- and postoperative complications were detected. On 3—5 days after the procedure all patients were discharged in satisfactory condition under the supervision of the oncologist at the place of residence. Conclusion. Mechanical jaundice caused by occlusion of the previously placed uncovered SES due to tumor tissue sprouting of its framework is one of the late complications of bilioduodenal stenting. Our experience demonstrates new possibilities to restore the lumen of an occluded stent using ERFA, the method demonstrated high technical and clinical efficacy in the presented series of observations.