Surgical Treatment Of Bismuth-Corlette Type â…¢b Hilar Cholangiocarcinoma: Case Report And Literature Review

AIMTo evaluate photodynamic therapy as an alternate treatment modality in patients diagnosed with unresectable hilar cholangiocarcinomaMethodsCase studies involving the use of photodynamic therapy as a treatment modality with or without combination therapy from 1998-2014 were analyzed and well as preclinical trials in mice models. Cases were searched for on PubMed(https://www.ncbi.nlm.nih.gov/pubmed), US National Library of Medicine (NCBI), MED1INE (http://webof knowledge.com/MED1INE), EMBASE (https://www.embase.com), The Cochrane center (https://china.cochrane.org), Chinese database (http://g.wanfangdata.com.cn), (http://www.chkd.cnki.net)ResultsIn a review study,32 patients were treated with PDT alone (group A), and thirteen patients were treated with PDT using single operator cholangioscopy (SOC) (group B), and were analyzed retrospectively. Median survival time was 200 days in group A and 386 days in group B (p= 0.45). Results showed that SOC results in significantly lower fluoroscopy time of 11.1min versus 21.1min (p< 0.0001), which helps both the patient and staff educe exposure to radiation (60). Another study in 2014, Hong et al published a retrospective comparative study on clinical data of 74 cases with unresectable HCCA who were divided into combined treatment group (n=16) and PDT alone group (n=58) according to the treatment modality. In this study, combined chemotherapy mainly used gemcitabine alone or gemcitabine with cisplatin and PDT with chemotherapy group. Results showed longer survival than PDT alone group. The median survival was 538 days vs 334 days.ConclusionThis review has shown feasibility and efficacy of the use of photodynamic therapy (PDT) in patients with unresectable hilar cholangiocarcinoma in both clinical and preclinical research. Furthermore, a combined modality such as PDT+Stent+ Chemotherapy or Radiotherapy has shown to improve survival in such patients. It is the author’s hope that with advancement in medical technology and research, the procedure can advance and governing medical bodies can approve the use of a PDT protocol as standard palliation approach for unresectable HCCA in the near future.