false
Catalog
ASGE Annual Postgraduate Course: Clinical Challeng ...
Biliary RFA
Biliary RFA
Back to course
[Please upgrade your browser to play this video content]
Video Transcription
I just wanted to show you a couple of things about biliary RFA. We use this for treatment of certain bile duct malignancies that are not amenable to surgical resection. Here's a 65 year old woman with multiple medical problems who had an ampullary high grade dysplastic adenoma. She had a successful endoscopic ampulectomy, but she had some sub-centimeter length of intraductally extending ampullary adenomas, so the referring endoscopist asked if I could use an RFA probe to do this. This is a 10 French device, and I just wanted to share with you the settings that I prefer. I have an Irby Bio electrosurgical generator. I use soft coag, I set it on 7 watts, effect 8. Remember this is bipolar device, so there's no ground pad. I step on the pedal for 90 seconds. Some people like two minutes. I use 90 seconds. I wait about three minutes before I withdraw the probe, thinking that that may reduce the risk of bleeding somewhat, and our entire group of ERCPists leaves a stent behind after this. This has a couple of electrodes. The burn goes just a couple of millimeters deep, and as you can see, a little bit of an indentation where that intraductal tumor is as I inject there, and this is the probe, so I try to make sure that the electrodes are in the area where that tumor is, and step on the pedal for 90 seconds. It goes in over a guide wire, and at the end, over the same wire, place a stent. It's actually really simple to do it. This is the device. There's one of the electrodes going in, and the second electrode, I think you can see that, and then perform your treatments for 90 seconds, and then here goes the plastic stent being inserted, and then the patient comes back to have that retrieved in a couple of weeks.
Video Summary
In this video, the speaker shares their experience using biliary radiofrequency ablation (RFA) for the treatment of bile duct malignancies. They discuss a specific case of a 65-year-old woman with a high-grade dysplastic adenoma and the use of a 10 French RFA probe. The speaker explains their preferred settings, including soft coag, 7 watts, and 90 seconds of treatment. They also mention waiting three minutes before withdrawing the probe to reduce bleeding risk. The speaker emphasizes the simplicity of the procedure and mentions the placement of a stent after treatment. The video concludes with the expectation of the patient returning to have the stent removed in a few weeks. No credits were given in the transcript provided.
Keywords
biliary radiofrequency ablation
bile duct malignancies
RFA probe
high-grade dysplastic adenoma
soft coag
×
Please select your language
1
English