| [ Summary ] |
Photodynamic therapy (PDT) is one of the types of therapy which uses a photodynamic reaction created by intraction between the photosensitizer and a laser beam. Although there have been few reports on PDT usage in cases of bile duct cancer, several investigators have demonstrated good results in recurring cases of bile duct cancer at the anastomosis, with the bile duct and the jujunum, or inoperable bile duct cancers for release of stenosis using a hematoporphyrin derivative and an argon dye laser. We have performed PDT in seven inoperable bile duct cancers up to this time. PDT was performed using an excimer dye laser(wave length, 63Onm) under a percutaneous transhepatic cholangioscope at about 48 hours after intravenous injection of photofrin (2.0mg/kg). The condltions for irradiation were 4mJ/pulse (40Hz), 200mJ/cm2, and the mean quantities of work were 100J/cm2 in proportion to those for lung cancer. At two to four weeks after PDT, all biopsy specimens showed complete lack of adenocarcinoma and we were able to release stenosis in one case. However in lower bile duct carcinomas,acute pancreatitis must be noted as a complication of PDT. At the present time, it is difficult to perform curative therapy for advanced bile duct cancers by using only PDT, because it is only a therapy for use in particular regions. However in present results suggest that PDT may be useful for inoprerative and early bile duct cancers in the future because it is difficult to perform endoscopic mucosal resection in the bile duct. |