Book contents
- Frontmatter
- Contents
- FOREWORD
- ACKNOWLEDGMENTS
- CONTRIBUTORS
- PART I PRINCIPLES OF ONCOLOGY
- PART II PRINCIPLES OF IMAGE-GUIDED THERAPIES
- PART III ORGAN-SPECIFIC CANCERS
- 9 Hepatocellular Carcinoma: Epidemiology, Pathology, Diagnosis and Screening
- 10 Staging Systems for Hepatocellular Carcinoma
- 11 Hepatocellular Carcinoma: Medical Management
- 12 Surgical Management (Resection)
- 13 Liver Transplantation for Hepatocellular Carcinoma
- 14 Image-guided Ablation of Hepatocellular Carcinoma
- 15 Embolization of Liver Tumors: Anatomy
- 16 Transcatheter Arterial Chemoembolization: Technique and Future Potential
- 17 New Concepts in Targeting and Imaging Liver Cancer
- 18 Intrahepatic Cholangiocarcinoma
- 19 Medical Management of Colorectal Liver Metastasis
- 20 Surgical Resection of Hepatic Metastases
- 21 Clinical Management of Patients with Colorectal Liver Metastasis Using Hepatic Arterial Infusion
- 22 Colorectal Metastases: Ablation
- 23 Colorectal Metastases: Chemoembolization
- 24 Radioembolization with 90Yttrium Microspheres for Colorectal Liver Metastases
- 25 Carcinoid and Related Neuroendocrine Tumors
- 26 Interventional Radiology for the Treatment of Liver Metastases from Neuroendocrine Tumors
- 27 Immunoembolization for Melanoma
- 28 Preoperative Portal Vein Embolization
- 29 Cancer of the Extrahepatic Bile Ducts and the Gallbladder: Surgical Management
- 30 Extrahepatic Biliary Cancer: High Dose Rate Brachytherapy and Photodynamic Therapy
- 31 Extrahepatic Biliary Cancer/Biliary Drainage
- 32 Surgical and Medical Treatment
- 33 Percutaneous Renal Ablation
- 34 Embolotherapy in the Management of Renal Cell Carcinoma
- 35 Epidemiology, Diagnosis, Staging and the Medical-Surgical Management of Lung Cancers
- 36 Image-guided Ablation in the Thorax
- 37 Interventional Treatment Methods for Unresectable Lung Tumors
- 38 Interventional Neuroradiology in Head and Neck Oncology
- 39 Percutaneous Ablation of Painful Metastases Involving Bone
- 40 Intra-arterial Therapy for Sarcomas
- 41 Prostate Cryoablation: A Role for the Radiologist in Treating Prostate Cancer?
- PART IV SPECIALIZED INTERVENTIONAL TECHNIQUES IN CANCER CARE
- INDEX
- Plate section
- References
30 - Extrahepatic Biliary Cancer: High Dose Rate Brachytherapy and Photodynamic Therapy
from PART III - ORGAN-SPECIFIC CANCERS
Published online by Cambridge University Press: 18 May 2010
- Frontmatter
- Contents
- FOREWORD
- ACKNOWLEDGMENTS
- CONTRIBUTORS
- PART I PRINCIPLES OF ONCOLOGY
- PART II PRINCIPLES OF IMAGE-GUIDED THERAPIES
- PART III ORGAN-SPECIFIC CANCERS
- 9 Hepatocellular Carcinoma: Epidemiology, Pathology, Diagnosis and Screening
- 10 Staging Systems for Hepatocellular Carcinoma
- 11 Hepatocellular Carcinoma: Medical Management
- 12 Surgical Management (Resection)
- 13 Liver Transplantation for Hepatocellular Carcinoma
- 14 Image-guided Ablation of Hepatocellular Carcinoma
- 15 Embolization of Liver Tumors: Anatomy
- 16 Transcatheter Arterial Chemoembolization: Technique and Future Potential
- 17 New Concepts in Targeting and Imaging Liver Cancer
- 18 Intrahepatic Cholangiocarcinoma
- 19 Medical Management of Colorectal Liver Metastasis
- 20 Surgical Resection of Hepatic Metastases
- 21 Clinical Management of Patients with Colorectal Liver Metastasis Using Hepatic Arterial Infusion
- 22 Colorectal Metastases: Ablation
- 23 Colorectal Metastases: Chemoembolization
- 24 Radioembolization with 90Yttrium Microspheres for Colorectal Liver Metastases
- 25 Carcinoid and Related Neuroendocrine Tumors
- 26 Interventional Radiology for the Treatment of Liver Metastases from Neuroendocrine Tumors
- 27 Immunoembolization for Melanoma
- 28 Preoperative Portal Vein Embolization
- 29 Cancer of the Extrahepatic Bile Ducts and the Gallbladder: Surgical Management
- 30 Extrahepatic Biliary Cancer: High Dose Rate Brachytherapy and Photodynamic Therapy
- 31 Extrahepatic Biliary Cancer/Biliary Drainage
- 32 Surgical and Medical Treatment
- 33 Percutaneous Renal Ablation
- 34 Embolotherapy in the Management of Renal Cell Carcinoma
- 35 Epidemiology, Diagnosis, Staging and the Medical-Surgical Management of Lung Cancers
- 36 Image-guided Ablation in the Thorax
- 37 Interventional Treatment Methods for Unresectable Lung Tumors
- 38 Interventional Neuroradiology in Head and Neck Oncology
- 39 Percutaneous Ablation of Painful Metastases Involving Bone
- 40 Intra-arterial Therapy for Sarcomas
- 41 Prostate Cryoablation: A Role for the Radiologist in Treating Prostate Cancer?
- PART IV SPECIALIZED INTERVENTIONAL TECHNIQUES IN CANCER CARE
- INDEX
- Plate section
- References
Summary
CAUSES OF MALIGNANT OBSTRUCTIVE JAUNDICE
Various types of malignancies, including pancreatic cancer, cholangiocarcinoma, hepatocellular carcinoma, gallbladder carcinoma and metastatic disease, can cause malignant obstruction of the biliary ducts. Cholangiocarcinomas represent approximately 3% of all gastrointestinal cancers (1). It was estimated that approximately 18,500 primary liver cancers would be diagnosed in the United States in 2006 (2) and of these, approximately 15% would be intrahepatic cholangiocarcinomas (3). An estimated 4,600 cases of extrahepatic cholangiocarcinoma were diagnosed in 2007 per estimates from the American Cancer Society. Risk factors include primary sclerosing cholangitis, ulcerative cholitis, choledochal cysts and biliary infections, such as in typhoid carriers. Chemical exposures to nitrosamines, dioxin, asbestos and polychlorinated biphenyls have also been linked to cholangiocarcinoma. Cholangiocarcinomas are usually adenocarcinomas (95% of the time) but rarely are found to be cystadenocarcinomas, hemangioendotheliomas or mucoepidermoid carcinomas. Patients commonly present with right upper quadrant pain, pruritis, anorexia, malaise and weight loss. Up to 30% of patients may present with cholangitis. Elevated liver enzymes, alkaline phosphate and bilirubin can also be seen. Cholangiocarcinomas are usually discovered on ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP). Percutaneous transhepatic cholangiography and laparoscopy can also be used for diagnosis. If the cholangiocarcinoma appears resectable, a Whipple resection or partial hepatectomy can be attempted; with complete resection, 5-year survival rates of up to 25% are seen. Palliative surgery with a biliary bypass can be done in the event that resection is not possible.
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- Interventional OncologyPrinciples and Practice, pp. 346 - 357Publisher: Cambridge University PressPrint publication year: 2008