Palliation of irresectable hilar cholangiocarcinoma with biliary drainage and radiotherapy Journal Article


Authors: Kuvshinoff, B. W.; Armstrong, J. G.; Fong, Y.; Schupak, K.; Getradjman, G.; Heffernan, N.; Blumgart, L. H.
Article Title: Palliation of irresectable hilar cholangiocarcinoma with biliary drainage and radiotherapy
Abstract: Twelve patients with irresectable or recurrent hilar cholangiocarcinoma were treated with internal biliary drainage followed by intraluminal (iridium‐192) and external‐beam radiotherapy. Biliary drainage was accomplished by means of a combined surgical and interventional radiological approach. Initial biliary decompression was performed surgically by tumour resection, intrahepatic biliary enteric bypass or distal biliary‐enteric anastomosis with a temporary stent. Maintenance of internal biliary drainage and application of intraluminal radiotherapy were accomplished radiologically with the use of percutaneous dilatation and metallic expandable biliary endoprostheses. Median survival was 14.5 months; all 12 patients survived for at least 6 months. Early complications during radiotherapy were minor and included two patients with cholangitis and one with transient haemobilia. Jaundice was relieved in ten of 12 patients, while episodes of cholangitis were seen during long‐term follow‐up in 11 (median 1.5 episodes per patient). Internal biliary drainage, in conjunction with radiotherapy, appears to be safe and effective palliation of irresectable or recurrent hilar cholangiocarcinoma. Patients can maintain a reasonable quality of life with an acceptable incidence of cholangitis, without the hindrance of external drainage devices. Copyright © 1995 British Journal of Surgery Society Ltd.
Keywords: adult; cancer survival; clinical article; treatment outcome; aged; clinical trial; combined modality therapy; follow-up studies; palliative care; quality of life; neoplasm recurrence, local; palliative therapy; brachytherapy; bile duct carcinoma; bile duct neoplasms; cholangiocarcinoma; biliary tract drainage; iridium 192; iridium radioisotopes; drainage; bile duct cancer; stents; middle age; human; male; female; priority journal; article
Journal Title: British Journal of Surgery
Volume: 82
Issue: 11
ISSN: 0007-1323
Publisher: Oxford University Press  
Date Published: 1995-11-01
Start Page: 1522
End Page: 1525
Language: English
DOI: 10.1002/bjs.1800821122
PUBMED: 8535808
PROVIDER: scopus
DOI/URL:
Notes: Getradjman's last name is misspelled on the original publication -- Article -- Export Date: 28 August 2018 -- Source: Scopus
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  1. Leslie H Blumgart
    352 Blumgart
  2. Yuman Fong
    775 Fong
  3. Karen D Schupak
    72 Schupak