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World J Gastrointest Endosc. Nov 16, 2010; 2(11): 357-361
Published online Nov 16, 2010. doi: 10.4253/wjge.v2.i11.357
Photodynamic therapy: Palliation and endoscopic technique in cholangiocarcinoma
James A Richter, Michel Kahaleh
James A Richter, Michel Kahaleh, University of Virginia Health System, Charlottesville, VA 22908-0708, United States
Author contributions: Both Richter JA and Kahaleh M wrote and edited all portions of this manuscript; and Kahaleh M came up with the concept of the paper.
Correspondence to: Michel Kahaleh, MD, Director, Pancreatico-Biliary Services, Digestive Health Center Box 800708, University of Virginia Health System, Charlottesville, VA 22908-0708, United States. mk5ke@virginia.edu
Telephone: +1-434-2439259 Fax: +1-434-9240491
Received: June 3, 2010
Revised: August 25, 2010
Accepted: September 1, 2010
Published online: November 16, 2010

Cholangiocarcinoma is the primary malignancy arising from the biliary epithelium. The disease is marked by jaundice, cholestasis, and cholangitis. Over 50 percent of patients present with advanced stage disease, precluding curative surgical resection as an option of treatment. Prognosis is poor, and survival has been limited even after biliary decompression. Palliative management has become the standard of care for unresectable disease and has evolved to include an endoscopic approach. Photodynamic therapy (PDT) consists of administration of a photosensitizer followed by local irradiation with laser therapy. Several studies conducted in Europe and the United States have shown a marked improvement in the symptoms of cholestasis, survival, and quality of life. This article summarizes the published experience regarding PDT for cholangiocarcinoma and the steps required to administer this therapy safely.

Keywords: Cholangiocarcinoma, Cholestasis, Jaundice, Neoplasia, Palliation, Photodynamic therapy, Photofrin