Endoscopic management of hilar cholangiocarcinoma.
Summary of "Endoscopic management of hilar cholangiocarcinoma."
Hilar cholangiocarcinoma has a poor prognosis and surgery remains the only curative option. However, few patients are diagnosed at a curable stage and palliative therapies are, therefore, mandatory. Endoscopy could have a useful role in the work-up of patients with hilar cholangiocarcinoma who are unsuitable for surgery. Endoscopic retrograde cholangiopancreatography provides an opportunity to collect specimens for cytological or histological diagnosis, yet is often nondiagnostic. Other techniques, including fluorescence in situ hybridization, confocal laser endomicroscopy and endoscopic ultrasonography, are now improving the accuracy of tissue diagnosis. This Review presents an overview of the diagnostic and therapeutic role of endoscopic procedures in the management of hilar cholangiocarcinoma. The use of such procedures in guiding the therapeutic management of patients with hilar cholangiocarcinoma is discussed, and the relative success of endoscopic stenting as the main palliative therapy for obstructive jaundice (a common complication of hilar cholangiocarcinoma) is described. The potential role of photodynamic therapy as a palliative treatment for patients with hilar cholangiocarcinoma is also outlined.
Affiliation
Department of Gastroenterology, General Hospital of Sanremo, Via Borea 56, Sanremo 18038, Italy.
Journal Details
This article was published in the following journal.
Name: Nature reviews. Gastroenterology & hepatology
ISSN: 1759-5053
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22269953
- DOI: http://dx.doi.org/10.1038/nrgastro.2011.271
Medical and Biotech [MESH] Definitions
Cholangiopancreatography, Endoscopic Retrograde
Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.
Sphincterotomy, Endoscopic
Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.
Materials Management, Hospital
The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.
Management Quality Circles
Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.
Practice Management
Business management of medical and dental practices that may include capital financing, utilization management, and arrangement of capitation agreements with other parties.
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