Use of Histotripsy to Rapidly Relieve Biliary Obstruction in a Patient With Recurrent Hilar Cholangiocarcinoma.
Publication Title
The American surgeon
Document Type
Article
Publication Date
8-28-2025
Keywords
washington; swedish
Abstract
Hilar cholangiocarcinoma (HCCA) is a rare, aggressive cancer often diagnosed at an unresectable stage. Patients commonly require systemic therapy and biliary stenting to manage symptoms and maintain liver function. Histotripsy is a novel, non-invasive, mechanical ablation technique recently FDA-approved for liver tumors. We report the case of a 77-year-old woman with recurrent HCCA who experienced progressive biliary obstruction despite chemotherapy and irreversible electroporation. She underwent 2 staged histotripsy treatments targeting tumors in the left and right biliary systems. Procedures were well-tolerated, with no complications, and led to normalization of bilirubin within 72 hours. Imaging at 6 months showed stable disease and sustained biliary patency, with only 1 stent exchange needed. This case highlights the potential role of histotripsy in relieving biliary obstruction and controlling local disease in patients with HCCA.
Area of Special Interest
Cancer
Area of Special Interest
Digestive Health
Specialty/Research Institute
Oncology
Specialty/Research Institute
Hepatology
Specialty/Research Institute
Surgery
DOI
10.1177/00031348251358442
