Interventional treatment methods, fluorescent diagnostic and photodynamic therapy of nonre-sectable cholangiocarcinoma complicated by jaundice.

Shiryaev A.A., Musaev G.H., Levkin V.V., Reshetov I.V., Loshenov M.V., Borodkin A.V., Volkov V.V., Linkov K.G., Makarov V.I., Jemerikin G.A., Schekoturov I.O., Ru-ban M.A., Loshenov V.B.

Рurpose. To improve diagnostics and effectiveness of treatment in patients with unresectable cholan-giocarcinoma complicated by obstructive jaundice. Materials and methods. A total of 28 patients (100%) with unresectable or functionally in-operable cholangiocarcinomas complicated by obstructive jaundice were diagnosed and treated. All patients underwent percutaneous drainage of the ducts under the ultrasound control and fluoroscopy. After reduction of jaundice video fluorescent diagnostic was per-formed. There was used a special module for that, by means of which a video fluorescent im-age of the bile ducts tumor was obtained and the degree of photosensitizer accumulation in the tissues was determined. Following photosensitizers were used: Photosens, Radachlorin (Russia) and Photolon (Belorussia). After the videofluorescence diagnostics photodynamic therapy of tumor stricture was conducted. Photodynamic therapy was performed using a fiber-optic system, if necessary, a controllable balloon catheter on the distal segment was used allowing to conduct therapy throughout the stricture more evenly. For the restoration of biliary evacuation nitinol stents were used. Results. In all patients a videofluorescent image of the bile duct tumor was obtained and a high degree of photosensitizer accumulation was determined. At the same time 23 patients (82%) had a malignant lesion confirmed morphologically. The effectiveness of com-bined treatment in unresectable cholangiocarcinoma was evaluated by life expectancy, the highest was 29 months (mean 14±5 months), but some of patients were under dynamic con-trol for a period of 6 to 17 months. Conclusions. Usage of interventional treatment methods for patients with cholangio-carcinoma complicated by obstructive jaundice improves liver function and decreases jaun-dice. The combined use of minimally invasive technologies with fluorescent diagnostics and photodynamic therapy allows to increase the median life expectancy and improve the quality of patient’s life.

1 - I.M. Sechenov First Мoscow State Medical University (Sechenov University). 2 - A.M. Prokhorov Institute of General Physics. Moscow, Russia.

 

Keywords: liver, bile ducts, stricture, cholangiocarcinoma, videofluorescence diagnostics, photodynamic therapy, stenting

 

Corresponding author:Shiryaev A.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation:Shiryaev A.A., Musaev G.H., Levkin V.V., Reshetov I.V., Loshenov M.V., Borodkin A.V., Volkov V.V., Linkov K.G., Makarov V.I., Jemerikin G.A., Schekoturov I.O., Ru-ban M.A., Loshenov V.B. Interventional treatment methods, fluorescent diagnostic and photo-dynamic therapy of nonresectable cholangiocarcinoma complicated by jaundice. REJR 2018; 8(4):124-133. DOI:10.21569/2222-7415-2018-8-4-124-133.

Received: 25.10.18 Accepted: 11.11.18