Endoscopic Biliary Stent Placement with or without Radiofrequency Ablation in Treating Patients with Biliary Obstruction Arising From Pancreatic Cancer That Cannot Be Removed by Surgery

Inclusion Criteria

• Patients with any tumor obstructing the distal bile duct and causing an indwelling biliary SEMS occlusion
• Patients with jaundice or clinical cholangitis, with new elevation of alkaline phosphatase, total bilirubin, and imaging findings supportive of stent occlusion (loss of stent patency, debris within stent, loss of or excessive pneumobilia)

Exclusion Criteria

• Have altered gastro-duodenal or hepatobiliary anatomy such that endoscopic retrograde cholangiopancreatogram (ERCP) is felt to be unacceptably technically difficult or unsafe
• Have additional sites of biliary strictures (intrahepatic/hilar) such that ERCP stenting is felt to be unlikely to provide adequate clinical benefit
• Have cardiac pacemakers
• Have Child B/C cirrhosis
• Are pregnant
• Are unsuitable for endoscopy (either because of hemodynamic instability, respiratory distress or unsafe hematological parameters such as refractory anemia < 7 g/dL, thrombocytopenia < 50 K/mcL, or coagulopathy with international normalized ratio [INR] > 2.0)
• Have biliary strictures not technically amenable to endoscopic therapy