Intraductal radiofrequency ablation (ID-RFA) has been introduced as a therapeutic option for residual or recurrent ampullary tumors after endoscopic papillectomy. However, papillary stenosis is a common adverse event. We evaluated the incidence of papillary stenosis following ID-RFA and investigated potential risk factors.

We conducted a retrospective review of patients who underwent ID-RFA for residual or recurrent ampullary tumors after papillectomy at a single tertiary center (May 2019–October 2024). ID-RFA was performed using an 18- or 22-mm ELRA catheter (Taewoong, Seoul, South Korea) placed in the lower common bile duct under fluoroscopic guidance, with 10 W at 75 °C delivered by a VIVA Combo generator (STARmed, Seoul, South Korea). Clinical outcomes and the occurrence of papillary stenosis were analyzed, and risk factors were assessed using univariate analysis.

A total of 14 patients (median age, 60 years; range, 43–83; 6 females) underwent ID-RFA. Two were excluded due to surgical resection after ID-RFA or incomplete ablation, leaving 12 patients for analysis. During follow-up, no tumor recurrence was observed. Papillary stenosis developed in 8 patients (66.7%). Comparisons between patients with and without stenosis showed no significant differences in the interval between papillectomy and ID-RFA (9.8 ± 13.3 vs. 5.5 ± 4.2 months, P = 0.542), ablation duration (120 ± 56 vs. 150 ± 60 s, P = 0.410), or stent placement duration (45.1 ± 8.4 vs. 30.0 ± 16.2 days, P = 0.55).

ID-RFA is an effective treatment for residual or recurrent ampullary tumors following endoscopic papillectomy, with no recurrences observed in this cohort. However, papillary stenosis was a frequent adverse event, occurring in two-thirds of patients. No significant risk factors were identified. Larger, comparative studies are required to establish optimal strategies for stent type and placement duration to minimize this complication.