Fig. 2. Endoscopic retrograde cholangiography (ERCP)-guided intraductal radiofrequency ablation (ID-RFA). (A) ERCP revealing intraductal filling defects in the distal common bile duct (CBD). (B) Cholangiography depicting the endoluminal radiofrequency ablation (ELRA) catheter® (Starmed, Goyang, Korea) in the distal CBD stricture along the guidewire. ERCP-guided ID-RFA was applied at 80°C and 10 W for 120 seconds. (C) Endoscopic image showing the ELRA RFA catheter and ablated tumor tissue following balloon retrieval. (D) At the end of the procedure, a biliary self-expanding metal stent was placed in the post-RFA stricture site after ID-RFA.
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