Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy
ABSTRACT Background: Cholangiocarcinoma is an aggressive neoplasm that usually requires palliative biliary drainage. Photodynamic therapy (PDT) has been described as a successful adjunct treatment to malignant biliary obstruction. Aim: To describe the use of digital cholangioscope to help provide...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Colégio Brasileiro de Cirurgia Digestiva
2020-11-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000100401&tlng=pt |
| _version_ | 1819005707665539072 |
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| author | Vítor Ottoboni BRUNALDI José Eduardo BRUNALDI José Dirceu VOLLET-FILHO Mariangela Ottoboni BRUNALDI José Celso ARDENGH Vanderlei Salvador BAGNATO José Sebastião DOS-SANTOS Rafael KEMP |
| author_facet | Vítor Ottoboni BRUNALDI José Eduardo BRUNALDI José Dirceu VOLLET-FILHO Mariangela Ottoboni BRUNALDI José Celso ARDENGH Vanderlei Salvador BAGNATO José Sebastião DOS-SANTOS Rafael KEMP |
| author_sort | Vítor Ottoboni BRUNALDI |
| collection | DOAJ |
| description | ABSTRACT Background: Cholangiocarcinoma is an aggressive neoplasm that usually requires palliative biliary drainage. Photodynamic therapy (PDT) has been described as a successful adjunct treatment to malignant biliary obstruction. Aim: To describe the use of digital cholangioscope to help provide laser light during biliary PDT session using locally developed light source. Method: Patient receives intravenous photosensitizer 24 h before the procedure. It starts with a regular duodenoscopy. After identification of the major papilla and retrograde cannulation, the digital cholangioscope is introduced into the common bile duct. Then, the cholangioscopic examination helps to identify the neoplastic stricture. Under direct visualization lighting catheter is advanced through the cholangioscope. Repositioning is recommended every centimeter to cover all strictured area. At the end of the procedure, a final cholangioscopy assesses the bile duct for the immediate result and adverse events. Result: This procedure was applied in one 82-year-old male due to obstructive jaundice in the last two months. EUS and ERCP revealed a severe dilation of the common bile duct associated with choledocholithiasis. Besides, was revealed dilation of hepatic duct up to a well-circumscribed hypoechoic solid mass measuring 1.8x2 cm compressing the common hepatic duct. The mass was deemed unresectable and the patient was referred for palliative treatment with PDT. He remained asymptomatic for three months. He perished due to complications 15 months after the PDT session. Conclusion: Digital cholangioscopy-guided biliary PDT is feasible and seems safe and effective as an adjunct modality in the palliation of extrahepatic cholangiocarcinoma. |
| first_indexed | 2024-12-20T23:57:04Z |
| format | Article |
| id | doaj.art-8e80a4977e1d4298a0adb2e99a0b971c |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-12-20T23:57:04Z |
| publishDate | 2020-11-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-8e80a4977e1d4298a0adb2e99a0b971c2022-12-21T19:22:43ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202020-11-0133110.1590/0102-672020190001e1490Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopyVítor Ottoboni BRUNALDIhttps://orcid.org/0000-0003-3315-8640José Eduardo BRUNALDIhttps://orcid.org/0000-0002-2911-7478José Dirceu VOLLET-FILHOhttps://orcid.org/0000-0002-9125-1694Mariangela Ottoboni BRUNALDIhttps://orcid.org/0000-0002-7404-6779José Celso ARDENGHhttps://orcid.org/0000-0002-5932-2499Vanderlei Salvador BAGNATOhttps://orcid.org/0000-0003-4833-239XJosé Sebastião DOS-SANTOShttps://orcid.org/0000-0001-5118-0361Rafael KEMPhttps://orcid.org/0000-0001-8008-2322ABSTRACT Background: Cholangiocarcinoma is an aggressive neoplasm that usually requires palliative biliary drainage. Photodynamic therapy (PDT) has been described as a successful adjunct treatment to malignant biliary obstruction. Aim: To describe the use of digital cholangioscope to help provide laser light during biliary PDT session using locally developed light source. Method: Patient receives intravenous photosensitizer 24 h before the procedure. It starts with a regular duodenoscopy. After identification of the major papilla and retrograde cannulation, the digital cholangioscope is introduced into the common bile duct. Then, the cholangioscopic examination helps to identify the neoplastic stricture. Under direct visualization lighting catheter is advanced through the cholangioscope. Repositioning is recommended every centimeter to cover all strictured area. At the end of the procedure, a final cholangioscopy assesses the bile duct for the immediate result and adverse events. Result: This procedure was applied in one 82-year-old male due to obstructive jaundice in the last two months. EUS and ERCP revealed a severe dilation of the common bile duct associated with choledocholithiasis. Besides, was revealed dilation of hepatic duct up to a well-circumscribed hypoechoic solid mass measuring 1.8x2 cm compressing the common hepatic duct. The mass was deemed unresectable and the patient was referred for palliative treatment with PDT. He remained asymptomatic for three months. He perished due to complications 15 months after the PDT session. Conclusion: Digital cholangioscopy-guided biliary PDT is feasible and seems safe and effective as an adjunct modality in the palliation of extrahepatic cholangiocarcinoma.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000100401&tlng=ptEndoscopyCholangiocarcinomaJaundiceCholangiopancreatography, endoscopic retrograde |
| spellingShingle | Vítor Ottoboni BRUNALDI José Eduardo BRUNALDI José Dirceu VOLLET-FILHO Mariangela Ottoboni BRUNALDI José Celso ARDENGH Vanderlei Salvador BAGNATO José Sebastião DOS-SANTOS Rafael KEMP Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy ABCD: Arquivos Brasileiros de Cirurgia Digestiva Endoscopy Cholangiocarcinoma Jaundice Cholangiopancreatography, endoscopic retrograde |
| title | Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy |
| title_full | Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy |
| title_fullStr | Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy |
| title_full_unstemmed | Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy |
| title_short | Photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy |
| title_sort | photodynamic therapy of extrahepatic cholangiocarcinoma using digital cholangioscopy |
| topic | Endoscopy Cholangiocarcinoma Jaundice Cholangiopancreatography, endoscopic retrograde |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000100401&tlng=pt |
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