经ERCP途径胆道子镜直视下胆管癌光动力治疗1例(附视频)

Photodynamic therapy for cholangiocarcinoma under direct visualization of cholangioscopy via ERCP: A case report (with video)

摘要:

对于无法手术切除的胆管恶性梗阻患者，经内镜或经皮途径胆管引流是主要姑息性治疗手段，既往X线透视引导下经内镜逆行胰胆管造影途径或者经皮经肝途径胆管恶性肿瘤光动力治疗（photodynamic therapy，PDT）联合胆道支架植入，有助于延长患者的生存期及提高生活质量，但存在无法对病灶进行精准定位照射的问题。本文报道1例67岁男性患者因胆总管低分化腺癌行经口胆道子镜直视下PDT治疗的案例，实现了对病灶的内镜直视下准确定位照射治疗。

Abstract:

For patients with unresectable malignant biliary obstruction due to cholangiocarcinoma, endoscopic or percutaneous biliary drainage represents the main palliative treatment. Previously, photodynamic therapy (PDT) for malignant biliary tumors via endoscopic retrograde cholangiopancreatography or percutaneous transhepatic approach under fluoroscopic guidance, combined with biliary stent implantation, has been shown to help prolong patient survival and improve quality of life. However, this strategy is limited by the inability to achieve precise targeted irradiation of the lesions.Herein, we report a case of a 67-year-old male patient with poorly differentiated adenocarcinoma of the common bile duct who underwent PDT under direct visualization using a peroral cholangioscope, enabling accurate localization and targeted irradiation of the lesion under endoscopic guidance.