Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

A Case of Benign Biliary Stricture as a Complication of Photodynamic Therapy for Biliary Papillomatosis

담관 유두종증 환자에서 광역동치료 후 발생한 양성 담관협착 1예

  • Choi, Mun-Ki (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Kim, Dong-Uk (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Kim, Gwang-Ha (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Song, Geun-Am (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Nam, Hyung-Seok (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Yi, Yang-Seon (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Ahn, Kang-Hee (Department of Internal Medicine, Pusan National University College of Medicine) ;
  • Eom, Jung-Seop (Department of Internal Medicine, Pusan National University College of Medicine)
  • 최문기 (부산대학교 의과대학 내과학교실) ;
  • 김동욱 (부산대학교 의과대학 내과학교실) ;
  • 김광하 (부산대학교 의과대학 내과학교실) ;
  • 송근암 (부산대학교 의과대학 내과학교실) ;
  • 남형석 (부산대학교 의과대학 내과학교실) ;
  • 이양선 (부산대학교 의과대학 내과학교실) ;
  • 안강희 (부산대학교 의과대학 내과학교실) ;
  • 엄중섭 (부산대학교 의과대학 내과학교실)
  • Published : 2011.05.30
⟨ Previous Next ⟩

Abstract

Biliary papillomatosis is a rare disease with a high risk of recurrence and malignant transformation. Therapeutic options include partial hepatectomy, Whipple's procedure and liver transplantation. If there is no surgical option left due to several reasons, local palliative procedures such as biliary stenting and drainage for the treatment of cholestasis are considered, but tumor growth cannot be influenced. Photodynamic therapy might be a new additional, palliative option for patients with biliary papillomatosis who are not eligible for surgery. Benign biliary stricture is a rare complication of photodynamic therapy. We report here a case of a 63-year-old male who developed benign biliary stricture after photodynamic therapy using the photosensitizer photofrin.

담관 유두종증은 매우 드문 질환이며, 재발률이 높고, 악성으로 변하는 전암 병변이기 때문에 근치적 절제술이 필요하다. 하지만, 여러 가지 이유로 수술적 치료가 어려운 경우에는 보존적 치료를 선택해야 한다. 광역동치료는 담관 유두종증의 새로운 유망한 보존적 치료로 안전성과 효과면에서 기존의 것에 비해 우월한 것으로 보인다. 하지만 광역동치료가 안정성과 생존율 그리고 삶의 질 향상에 미치는 영향에 대해서는 좀 더 많은 연구가 필요하다. 저자들은 간내 외 담관에 미만성으로 분포한 담관유두종증 환자에게 보존적 치료로써 시행한 광역동치료 후 양성 담관협착이 발생하여 문헌 고찰과 함께 보고한다.

Keywords

References

  1. Kim DK, Kim MH, Park KM, et al. A case of mucin-hypersecreting biliary papillomatosis: including review of Korean literatures. Korean J Gastrointest Endosc 2003;26:167-171.
  2. Kim HJ. Biliary papillomatosis. Korean J Gastroenterol 2005;46:149-151.
  3. Kim HK, Shin ES, Choe JW, et al. A case of biliary papillomatosis which underwent curative resection. Korean J Gastrointest Endosc 1998;18:111-115.
  4. Tireli M, Uslu A. Multiple biliary papillomatosis. HPB Surg 1992;6:125-127. https://doi.org/10.1155/1992/15823
  5. Hubens G, Delvaux G, Willems G, Bourgain C, Kloppel G. Papillomatosis of the intra- and extrahepatic bile ducts with involvement of the pancreatic duct. Hepatogastroenterology 1991;38:413-418.
  6. Seo DW, Kim MH, Lee SK, et al. Usefulness of cholangioscopy in patients with focal stricture of the intrahepatic duct unrelated to intrahepatic stones. Gastrointest Endosc 1999;49:204-209. https://doi.org/10.1016/S0016-5107(99)70487-6
  7. Shim CS. Photodynamic therapy in gastroenterology. Korean J Gastroenterol 2005;45:153-161.
  8. Ortner ME, Caca K, Berr F, et al. Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study. Gastroenterology 2003;125:1355-1363. https://doi.org/10.1016/j.gastro.2003.07.015
  9. Gu MJ, Choi JH. Biliary papillomatosis: a report of two cases. Korean J Pathol 2003;37:446-450.
  10. Koo HL, Yu ES. Biliary papillomatosis. Korean J Hepatol 2002;8:336-339.
  11. Bechmann LP, Hilgard P, Frilling A, et al. Successful photodynamic therapy for biliary papillomatosis: a case report. World J Gastroenterol 2008;14:4234-4237. https://doi.org/10.3748/wjg.14.4234
  12. Overholt BF, Panjehpour M, Haydek JM. Photodynamic therapy for Barrett's esophagus: follow-up in 100 patients. Gastrointest Endosc 1999;49:1-7. https://doi.org/10.1016/S0016-5107(99)70437-2
  13. Panjehpour M, Overholt BF, Phan MN, Haydek JM. Optimization of light dosimetry for photodynamic therapy of Barrett's esophagus: efficacy vs. incidence of stricture after treatment. Gastrointest Endosc 2005;61:13-18. https://doi.org/10.1016/S0016-5107(04)02394-6
  14. Dumoulin FL, Gerhardt T, Fuchs S, et al. Phase II study of photodynamic therapy and metal stent as palliative treatment for nonresectable hilar cholangiocarcinoma. Gastrointest Endosc 2003;57:860-867. https://doi.org/10.1016/S0016-5107(03)70021-2
  15. Lee EJ, Park SJ, Suh KS, et al. Benign biliary stricture mimicking bile duct carcinoma. Korean Journal of HBP Surgery 1999;3:99-108.
  16. Ortner MA. Photodynamic therapy for cholangiocarcinoma: overview and new developments. Curr Opin Gastroenterol 2009;25:472-476. https://doi.org/10.1097/MOG.0b013e32832e6e1f
  17. Mackenzie GD, Dunn JM, Selvasekar CR, et al. Optimal conditions for successful ablation of high-grade dysplasia in Barrett's oesophagus using aminolaevulinic acid photodynamic therapy. Lasers Med Sci 2009;24:729-734. https://doi.org/10.1007/s10103-008-0630-7
  18. Allison RR, Downie GH, Cuenca R, Hu XH, Childs CJ, Sibata CH. Photosensitizers in clinical PDT. Photodiagnosis Photodyn Ther 2004;1:27-42. https://doi.org/10.1016/S1572-1000(04)00007-9
  19. Allison RR, Sibata CH. Photofrin photodynamic therapy: 2.0 mg/kg or not 2.0 mg/kg that is the question. Photodiagnosis Photodyn Ther 2008;5:112-119. https://doi.org/10.1016/j.pdpdt.2008.05.004