Search PubMedSearch

PubMed · 9703645

[Interventional palliative therapy].

Abstract

From diagnostic procedures interventional radiology has developed a large number of therapeutic methods that have found a place in the treatment of palliative care patients. Minimal invasiveness and high efficiency characterise the implantation of metallic stents in the treatment of malignant biliary or esophageal obstruction and vena cava compression syndrome. Transcatheter arterial embolisation, chemoembolisation and chemoinfusion for palliative treatment of inoperable liver malignomas are performed at many centers. A specific concept and an accepted spectrum of indications have to be better defined by prospective trials. Therapeutic decisions in this patient group have to based on the individual case. The interventional radiologists is increasingly involved in the interdisciplinary decision making process.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

R Fischbach, K Lackner, P Landwehr, W Heindel. 1998. [Interventional palliative therapy].. https://pubmed.ncbi.nlm.nih.gov/9703645/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Diagnostic p53 immunostaining of endobiliary brush cytology: preoperative cytology compared with the surgical specimen.

BACKGROUND: Endobiliary brush cytology is important in the distinction of malignant and benign causes of extrahepatic bile duct obstruction. The additional diagnostic value of p53 immunostaining on these cytology specimens was assessed. METHODS: All patients with extrahepatic bile duct obstruction who underwent endoscopic retrograde cholangiopancreatography (ERCP) with endobiliary brush cytology and subsequent surgery at the Academic Medical Center in Amsterdam during a 3-year period were studied. p53 Immunocytology was compared with the corresponding conventional light microscopic cytology and p53 immunostaining of the subsequent surgical specimen. RESULTS: Fifty-three patients with the following diagnoses were included: pancreatic carcinoma (23), bile duct carcinoma (15), ampullary carcinoma (5), lymph node metastases (2), carcinoma of unknown origin (4), chronic pancreatitis (3), and primary sclerosing cholangitis (1). Fifty-one percent of the carcinomas showed positive p53 immunostaining; all four surgical specimens without carcinoma were negative. The sensitivities of conventional light microscopic cytology, p53 immunocytology, and both tests combined were 29%, 24%, and 43%, respectively. These sensitivities were higher in cases of bile duct carcinoma (46%, 40%, and 66%) compared with cases of pancreatic carcinoma (13%, 9%, and 22%). Specificities of both tests were 100%. CONCLUSIONS: p53 Immunostaining on endobiliary brush cytology may be helpful in the diagnosis of malignant extrahepatic bile duct stenosis, especially in patients with bile duct carcinoma. Cancer (Cancer Cytopathol)

Bile Duct Neoplasms

Laparoscopic biliary and enteric bypass.

Very few patients with a periampullary neoplasm present with resectable disease. Consequently, various operative and non-operative techniques have been developed to palliate patients with unresectable periampullary disease. Laparoscopic biliary (cholecystojejunostomy) and enteric bypass (gastrojejunostomy) are reasonable options as compared to their open counterparts for operative palliation. However, only a limited number of carefully selected patients meet selection criteria for laparoscopic palliation.

Bile Duct Neoplasms