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.
The majority of patients are not surgical candidates,
so other therapies are required...
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,
nausea and vomiting.
They were distributed...
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.