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[Malignant biliary obstruction].
- Source :
-
Casopis lekaru ceskych [Cas Lek Cesk] 2016; Vol. 155 (1), pp. 30-7. - Publication Year :
- 2016
-
Abstract
- Pancreatic cancer and cholangiocarcinoma are the most common causes of malignant biliary obstruction. They are diseases of increasing incidence and unfavorable prognosis. Only patients with localized disease indicated for surgery have a chance of long-term survival. These patients represent less than 20 % of all patients, despite the progress in our diagnostic abilities.Locally advanced and metastatic tumors are treated with palliative chemotherapy or chemoradiotherapy; the results of such treatments are unsatisfactory. The average survival of patients with unresectable disease is 6 months and only 5-10 % of patients survive 5 years.Biliary drainage is an integral part of palliative treatment. Endoscopically or percutaneosly placed stents improve quality of life, decrease cholestasis and pruritus, but do not significantly improve survival. Biliary stents get occluded over time, possibly resulting in acute cholangitis and require repeated replacement.Photodynamic therapy and radiofrequency ablation, locally active endoscopic methods, have been increasingly used in recent years in palliative treatment of patients with malignant biliary obstruction. In photodynamic therapy, photosensitizer accumulates in tumor tissue and is activated 48 hours later by light of a specific wave length. Application of low voltage high frequency current during radiofrequency ablation results in tissue destruction by heat. Local ablation techniques can have a significant impact in a large group of patients with malignant biliary obstruction, leading to improved prognosis, quality of life and stent patency.
- Subjects :
- Adenocarcinoma therapy
Aged
Common Bile Duct Diseases etiology
Common Bile Duct Diseases therapy
Drainage
Duodenal Obstruction etiology
Endoscopy
Female
Humans
Male
Middle Aged
Palliative Care methods
Pancreatic Neoplasms therapy
Quality of Life
Stents
Adenocarcinoma complications
Duodenal Obstruction therapy
Pancreatic Neoplasms complications
Subjects
Details
- Language :
- Czech
- ISSN :
- 0008-7335
- Volume :
- 155
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Casopis lekaru ceskych
- Publication Type :
- Academic Journal
- Accession number :
- 26898789