May 17, 2001

Palliative treatment in patients with unresectable hilar cholangiocarcinoma: results of endoscopic drainage in patients with type III and IV hilar cholangiocarcinoma

The European Journal of Surgery = Acta Chirurgica
M F GerhardsD J Gouma

Abstract

To find out how patients fared after palliative endoscopic biliary drainage for inoperable hilar cholangiocarcinoma. Retrospective study. University hospital, the Netherlands. Between 1992 and 1999, 41 patients who were referred for resection had tumours that were considered unresectable after additional investigations, including an exploratory laparotomy in 16 patients. In all patients, biliary drainage was established by endoscopic retrograde cholangiography (ERCP) and insertion of endoprostheses. Twelve patients also had percutaneous transhepatic biliary drainage (PTBD). The patients who did not have an exploratory laparotomy had fewer complications (1/25) than those who had explorations (4/16). All patients in both groups had one or more long-term complications during follow-up, of which cholangitis, jaundice, and abdominal pain were the most often recorded. In 32 patients, endoprostheses had to be replaced, a mean of 4 times. Median survival was 9 months, with no significant difference between the groups (8 and 11 months). Adjuvant radiotherapy had no influence on survival. The patients in this series had relatively long survival times, during which they had a substantial number of complications predominantly related to bi...Continue Reading

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Mentioned in this Paper

Endoscopy (Procedure)
perfluoro-2,2,2',2'-tetramethyl-4,4'-bis(1,3-dioxolane)
Yellow Skin or Eyes (Symptom)
Immunologic Adjuvants
Adjuvant
Abdominal Pain
Cholangiocarcinoma
Neoplasms
Retrograde Degeneration
Tumor Lysis Syndrome

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