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Six‐year recurrence free survival after intraluminal iridium‐192 therapy of human bilobar biliary papillomatosis
Author(s) -
Gunvén Peter,
Gorsetman Jakob,
Ohlsén Hans,
Rudén BengtInge,
Lundell Göran,
Skoog Lambert
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20000701)89:1<69::aid-cncr10>3.0.co;2-9
Subject(s) - medicine , electrocoagulation , papillomatosis , liver transplantation , surgery , transplantation , cryosurgery , cholecystectomy , percutaneous , radiology , pathology
BACKGROUND Biliary papillomatosis is rare and often fatal. Liver resection or transplantation is recommended but may be impossible due to tumor or patient factors; furthermore, it appears to the authors of this study that no follow‐up results after transplantation have been reported in previous studies. METHODS Bilobar but limited biliary papillomatosis in a man age 54 years was mapped by cholangiopancreatography, cholecystectomy, and operative cholangioscopy. After cholangioscopic electrocoagulation, iridium‐192 wires were temporarily inserted into the affected bile ducts, giving a dose of 60 grays at a 3‐mm distance. Another percutaneous cholangioscopic electrocoagulation was performed 3 weeks later. RESULTS The patient has been free of tumor and in good health for 80 months, but he has a long term stenting of a nonneoplastic stricture at the confluence of the bile ducts. CONCLUSIONS Mechanical tumor reduction and intraluminal brachytherapy could possibly replace transplantation (which up to now has been suggested but not reported) when this life‐threatening disease is bilobar, and also possibly replace liver resection for limited tumors in patients who are too frail for surgery. Cancer 2000;89:69–73. © 2000 American Cancer Society.