APC and RFA Combination Treatment for Ampullary Lesions with Intraductal Extension
Earlier this year a paper came out of Europe on the management of ampullary adenomas, which concluded that the RFA prodecure could be a potentially good alternative for non-surgical candidates. This particular article looked at three cases.
A new article out of USA has since been published, looking at a series of four cases, although this time the cases were of ampullary lesions with intraductal extension. The authors detailed a combination treatment of APC (Argon Plasma Coagulation, ERBE, for exposed tissue in the duodenum) and endobiliary RFA (Habib EndoHPB, EMcision, for difficult to access tissue within the duct) after ampullary resection.
The authors detailed some of the challenges faced in treating such complex cases, but also concluded that RFA may represent the first viable treatment adjunct for the challenging scenario.
How often do you come across these kinds of lesions? How do you approach them?