Non-Surgical Treatment of Bile Duct Cancer

Seiyo Ikeda

First Department of Surgery, School of Medicine, Fukuoka University

Non-surgical treatment of bile duct cancer regarding biliary endoprothesis (stenting) is described. The procedure includes endoscopic as well as percutaneous transhepatic approach. The indication of each procedure depends upon the characteristics of the lesion, and the technical feasibility is to be also considered. There are two kinds of prosthesis, namely plastic tube stent and expandable metallic stent (EMS). The former costs less and has advantage in removability compared with metallic stent. However, it is likely to be occluded with clogging. In contrast, the EMS can be of better patency due to its large size in diameter, and multiple stents can be placed stimultaneously. Regarding the disadvantages of EMS, it is expensive and cannot be removed once it applied. Tumor ingrowth is a major late complication of EMS. To maintain patency, other procedures such as radiation, chemotherapy and hyperthermia is to be considered combined with EMS, which may contribute to further improvement of survival as well as quality of life in patients with non-resectable bile duct cancer.

Key words
bile duct cancer, biliary endoprosthesis, expandable metallic stent

Reprint requests
Seiyo Ikeda First Department of Surgery, School of Medicine, Fukuoka University 7-45-1 Nanakuma, Jyonan-ku, Fukuoka, 814-0133 JAPAN

Accepted
November 13, 1998

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