Aims and objectives
Cholangiocarcinoma is the second most common primary malignant tumor of the liver.
Klatskin tumor or hilar cholangiocarcinoma represents more than 50% of all biliary tract cholangiocarcinomas .
The natura history of Klatskin tumors is dramatic.
The median survival without interventions reaches three months,
and it may be prolonged by drainage from four to ten months .
The patients die mainly due to jaundice,
complications of portal hypertension and cachexia....
Methods and materials
The intraprocedural adverse events of 159 EPDT’s performed in 62 biopsy confirmed non-surgical Klatskin tumor patients in a ten-year period were studied.
The endobiliary light delivery was fulfilled though the previously inserted percutaneous transhepatic biliary drainage channels by mean of a 600 µm in diameter optical fiber with a 2 to 6 cm diffuser tip after prior 2 to 5 hours i.v.
injection of chlorin photosensitizers ( Fig. 5 ).
Intraprocedural adverse events included pain,
Eight and 4 patients (5,4% and 2,7% per procedure)experienced intraoperative adverse events grade 2 and 3 events,
No significant influence of total dose,
diffuser tip length,
number of channels,
photoexposure time has been demonstrated.
The grade 2 adverse events were frequently observed when Fotolon was used (p<0,05,
Fisher`s exact test),
but further investigation are required due to small number of cases ( Fig. 7 ).
Endobiliary PDT is effective and well tolerated procedure.
Small number of intraprocedural adverse events hampers identification of factors influencing EPDT tolerability.
1) Suarez-Munoz M.A.,
Risk factors and classifications of hilar cholangiocarcinoma.
World Journal of Gastrointestinal Oncology 2013; 5: 7: 132— 138. 2) Park J. et al.
Natural History and Prognostic Factors of Advanced Cholangiocarcinoma without Surgery,
or Radiotherapy: A Large-Scale Observational Study // Gut Liver.