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Results for “Biliary Tract Neoplasms”

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At least 19 recordsLinked to original sources
PubMed2004

Biliary tract neoplasms: update 2003.

PURPOSE OF REVIEW: Biliary tract neoplasm is one of the most aggressive malignancies, with a very poor prognosis. Most cancers of the biliary tract will have grown beyond the limits of curative resection by the time they become clinically evident. This reality has fostered therapeutic nihilism, and most physicians and surgeons, in their pessimism, have to run ambitious trials evaluating new diagnostic tools and therapeutic techniques in this disease. RECENT FINDINGS: Advances in imaging over the period of the last 5 years now allow for earlier diagnosis and better surgical planning. Recent improvements in operative technique have substantially improved the outlook of patients with this cancer. Palliative management of obstructive disease recently has been improved with the advent of photodynamic therapy. Among the different drugs tested in this disease, gemcitabine seems to have the best efficacy:toxicity ratio. However, efficacy results remain disappointing, and combination schedules need to be developed to improve the results. Among them, the gemcitabine-oxaliplatin combination seems to be one of the most promising schedules. Biological studies, especially those evaluating mutation-independent activation of the Hedgehog pathway, have provided interesting information on the carcinogenesis of this rare tumor. Furthermore, these results bring us the opportunity of development of future targeted therapies in biliary tract cancer. SUMMARY: Biliary tract neoplasm remains one of the most aggressive malignancies. However, as for other gastrointestinal malignancies, biological studies and diagnostic and therapeutic improvements have provided interesting results that could lead to a major improvement in the prognosis of this disease.

Adenocarcinoma↗
PubMed1976

Operative endoscopy in the management of biliary tract neoplasms.

Operative endoscopy of the biliary system has been employed with ever increasing frequency at the UCLA Hospital during the last three years. In addition to its established value with respect to disclosing unsuspected stones in the bile ducts, choledochoscopy has been of great value in terms of more accurate diagnosis and staging of periampullary and bile duct neoplasms. It has been observed that many biliary tract carcinomas are multicentric in origin and that cholangiography is not adequate to identify small intrahepatic ductal lesions. More than one cell type of bile duct carcinoma may be present in the same patient. Choledochoscopy should be used in addition to the conventional criteria for resectability in all patients with ductal or periampullary carcinoma. Use of this technic will spare some patients needless radical procedures and should improve long-term cure rates by identifying those patients with truly localized disease for curative resections.

Adenocarcinoma↗
PubMed1999

Activation of telomerase and its diagnostic application in biopsy specimens from biliary tract neoplasms.

BACKGROUND: Telomerase activity has been reported to have potential as a useful diagnostic marker for cancer in various organs. The authors previously reported that telomerase activity in pancreatic juice differentiates pancreatic ductal carcinoma from adenoma and pancreatitis. In the current study, the usefulness of semiquantitatively determined telomerase activity in the diagnosis of malignant biliary tract neoplasms was investigated. METHODS: The samples examined included 61 surgically resected biliary tract tissues (11 gallbladder carcinomas, 5 bile duct carcinomas, 1 gallbladder adenoma, 30 cholecytitis cases, 7 cholesterol polyps, 1 normal gallbladder, and 6 normal common bile duct tissues), 42 bile samples from patients with biliary tract or pancreatic disease (19 cases of malignant biliary tract disease, 11 cases of benign biliary tract disease, 10 cases of malignant pancreatic disease, and 2 cases of benign pancreatic disease), and 14 bile duct biopsy specimens collected by percutaneous transhepatic choledochoscopy or endoscopic retrograde cholangiopancreatography (8 bile duct carcinoma specimens, 1 bile duct adenoma specimen, and 5 hepatolithiasis specimens). RESULTS: In biliary tract tissues, a telomerase ladder was detected in 73% of gallbladder carcinomas, 40% of bile duct carcinomas, and none of the other biliary tract tissues. One gallbladder adenoma showed a weak telomerase ladder. The telomerase ladder was detected in the bile sample from 1 patient (5.3%) with malignant biliary tract disease, none of the patients with benign biliary tract disease, 5 patients (50%) with malignant pancreatic disease, and none of the patients with benign pancreatic disease. In biopsy specimens, the telomerase ladder was detected in 75% of patients with bile duct carcinoma but not in any of the patients with hepatolithiasis. The median value of relative telomerase activity in the patients with bile duct carcinoma was significantly higher than that in the patients with hepatolithiasis. The diagnosis of bile duct carcinoma was confirmed preoperatively by histopathologic examination in only 25% of the biopsy specimens. CONCLUSIONS: The results of the current study indicate that telomerase is highly activated in biliary tract carcinomas and that the detection of a telomerase ladder in biopsy samples is an excellent tool for the diagnosis of bile duct carcinomas.

Amino Acid Sequence↗
PubMedDate not supplied

Biliary tract neoplasms.

From January 1993 to December 1995, complete records of patients with biliary neoplasms were analysed. A total of 124 patients were registered. Majority of patients were in the age range of 40-60 years (median 54 years). There were 38 males and 86 females. Histopathologically, adenocarcinoma was the commonest type (59%). Pain, jaundice and lump were noticed in 119, 54 and 77 patients respectively. Fifty six patients had associated gall stones. Ninety patients had metastatic disease at presentation. Majority of them (110/124) had advanced, inoperable disease and therefore were considered for palliative treatment. Only 14 patients (12%) were considered for curative treatment. Of these 14 patients, all the cases underwent surgery, 10 received radiotherapy and 10 received chemotherapy. Follow up was very poor. The survival of 14 patients, who received curative treatment, ranged from 2 months to 44 months with mean of 16 months.

Adenocarcinoma↗
PubMed1984

Biliary tract neoplasms: a simple management technique.

This paper presents a simple, fast, and accurate afterloading method of delivering high radiation dose to tumors of the biliary tract, using radioactive iridium through a biliary drainage catheter. A Tuohy Borst sidearm adaptor permits concurrent drainage. The dose delivered in this manner can be used to supplement the palliative external beam radiotherapy, with minimal side effect.

Adult↗
PubMed1997

[Surgical treatment of biliary tract neoplasms].

The authors present their own experiences concerning the treatment of the 34 patients with the benign and malignant tumors of the biliary tract. In the group of patients with malignant tumors, the type and extent of the surgery were dictated by the stage of the disease. Patients with benign tumors were subjected to resection of the region of bile duct bifurcation with Roux-Y hepaticojejunostomy.

Adolescent↗