Publisher： Karger
E-ISSN： 2297-475x|20|4|286-292
ISSN： 2297-4725
Source： Visceral Medicine (formerly: Viszeralmedizin), Vol.20, Iss.4, 2004-12, pp. : 286-292
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Abstract
Carcinomas of the biliary tree are rare tumors of the gastrointestinaltract with rising incidence during the lastyears. Biliary neoplasms are classified into intra- and extrahepaticcholangiocarcinomas (Klatskin tumor, middleand distal extrahepatic tumors), gallbladder cancer, andampullary carcinoma. Endoscopic therapy plays a centralrole in the palliative treatment of bile duct carcinoma.In obstructive jaundice, biliary drainage has few complicationsand relieves symptoms reliably. It can preventfurther complications and is indispensable to the treatmentof cholangitis. The principal drawbacks of biliarystents are stent occlusion and cholangitis. Prophylacticantibiotics were not proven to be effective. Technical detailsconcerning material, number and location of stentsawait further clarification. If existing biliary drainage isinsufficient, photodynamic therapy is an already establishedadjunct to palliative therapy for progressed hilarcholangiocarcinomas since it prolongs survival and improvesquality of life. Palliative radio-, chemo-, and radiochemotherapyshould be reserved to studies for lackof sufficient data. New therapeutical approaches includebrachytherapy as well as the use of modern chemotherapeuticals,COX-2 and receptor tyrosine kinase inhibitors.
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