Endoscopisch toegediende radiofrequente ablatie als behandeling van een verstopte metalen galwegstent

• Patients with unresectable malignant common bile duct obstruction caused by pancreatic head carcinoma or distal cholangiocarcinoma who have been treated previously with a biliary SEMS

• Recurrent biliary obstruction caused by SEMS occlusion due to tissue in- or overgrowth, requiring treatment

• A clinical diagnosis of obstructive jaundice in combination with a bilirubin level of > 40 μmol/L and

• Age 18 years or older

• Informed consent

Baseline:

• Patients with a (malignant) biliary obstruction due to other causes than pancreatic head cancer or cholangiocarcinoma

• Evidence of new additional more proximally located biliary strictures

• Clinical suspicion of cholangitis, defined as biliary obstruction in combination with fever (temperature ≥ 38,5°C)

• Presence of a plastic stent in the common bile duct.

• Patients who are unable to undergo ERCP due to their medical condition

• Patients suffering form concurrent gastric outlet obstruction

• Patients with a cardiac pacemaker

• Patients with a WHO performance score of 4

• Patients with a poor mental condition or mental retardation, unable to understand the nature and possible consequences of the study



Endoscopic:

• Failure to reach the ampulla of Vater.

• Failure to place a guidewire across the stricture.

• Re-obstruction not caused by tumour in- or overgrowth