Abstract

Background: advantages of endobiliary photodynamic therapy (PDT) described in the first part of review, namely: the safety of the intervention, the predictability and reproducibility of the effect, the absence of rough scarring of bile ducts, the possibility of repeating of procedures, affordability financially and economically - make this technology preferred among others locoregional effects in patients with hilus cholangiocarcinoma.

Aim: was to get a clinical specialist' view of endobiliary PDT as the perspective method: to describe dynamics of photosensitizer (PS) accumulation by tumor in vivo, to describe tools for delivering light into the lumen of bile ducts and intervention technique, to describe characteristics of light dosimetry, and to analyze immediate and long-term results of intra-duct photo exposure.

Material and methods: 66 domestic and foreign literary sources were analyzed.

Conclusion: endobiliary photodynamic therapy is a safe and effective method of locoregional treatment of patients with hilar cholangiocarcinoma, which significantly increases the duration and improves the quality of life of previously considered incurable patients.

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Abstract

Background: hilar cholangiocarcinoma (Klatskin tumor) is a rare and severe hepatobiliary malignancy of proximal bile ducts with dismal prognosis, slow periductal growth, late metastatic spread and is mostly fatal due to local complications. Surgical resection is considered to be the only curative method to the date, but its results aren't satisfactory as the majority of patients (70-80%) aren't suitable surgical candidates due to a large tumor extent in local hilar area. Moreover, local recurrence rate reaches 80% over 7 years. Thus endobiliary loco-regional technologies have been proposed, one of which is a photodynamic therapy (PDT).

Aim: was to provide provide a preclinical rationale of PDT in Klatskin tumor patients: to describe principles and mechanisms of the method and summary experimental studies data; this can prepare the reader for the second part of the review, which is based on the analysis of clinical studies and can give practical orientation.

Material and methods: 63 domestic and foreign literature sources were analyzed.

Conclusion: endobiliary photodynamic therapy showed its safety and efficacy in many experimental studies and can successfully be applied in clinical practice. 

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