327 - EB-RFA for Refractory Benign Biliary Strictures: Promising Early Results in Small Cohort

Purpose: To evaluate the technical feasibility, clinical efficacy, and safety of EB radiofrequency ablation (RFA) for refractory benign biliary strictures.

Materials and Methods: A retrospective review was performed of 15 patients (mean age, 52.9 years; range, 19–87; 9 male) who underwent percutaneous endobiliary RFA between 2020 and 2024. All patients had prior interventions, including balloon dilation (14/15), stenting (10/15), and surgical revision (7/15). Technical success was defined as successful catheter traversal, RFA delivery, and drainage placement. Clinical success was defined as relief of cholestasis without unplanned reintervention. Outcomes assessed included patency, reintervention, adverse events, and final disposition.

Results: Mean catheter duration prior to intervention was 234 days (range, 38–882). The mean interval from prior intervention to RFA was 95 days (range, 24–288). Cholangiographic and cholangioscopic resolution of stricture was visualized post RFA in 100% (15/15). Technical and clinical success was achieved in 100% (14/14 evaluable). Stent/drain-free patency was 82% (9/11) at 3 months, 86% (6/7) at 6 months, and 100% (1/1) at 12 months. Adverse events were limited, with no cases of cholangitis within 90 days (0/15). Reintervention with RFA was not required in any patients (0/15).

Conclusion: Endobiliary RFA is technically feasible and clinically effective for refractory benign biliary strictures, demonstrating high technical success, encouraging short-term patency, and a low complication profile. These early results suggest EB-RFA may serve as a valuable adjunctive therapy in patients with limited treatment options. Importantly, this ongoing cohort continues to mature, and longer-term outcomes will clarify the durability and broader role of EB-RFA in benign biliary disease.