Long-term survival for 15 years after percutaneous transhepatic cholangioscopic and X-ray image-guided microwave tissue coagulation (MTC) in a jaundiced man with non-resected bile duct carcinoma
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概要
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Bile duct carcinoma is one of the most lethal and aggressive malignancies, with the majority of patients harboring unresectable tumors at presentation. The currernt conventional treatment for bile duct carcinoma is either bile duct resection with hepatectomy or pancreatoduodenectomy based on its location, according to the guidelines for diagnosis and treatment of bile duct carcinoma However, hepatectomy and/or PD is a major operation not well tolerated by jaundiced and aged patients in poor general condition with bile duct carcinoma.We previously reported an inoperable jaundiced woman with bile duct carcinoma who underwent cholangioscopic MTC and survived longer than 13 years.Here, we report another jaundiced patient with bile duct carcinoma with survival longer than 15 years after cholangioscopic MTC.Our method (MTC) uses not only coagulation but also mild hyperthermia on the tumor margins as well as on the ductal lumen. Effects other than hyperthermia such as those of microwave dynamic therapy are also currerntly under investigation.For some patients with bile duct carcinoma in poor general condition, with severe jaundice, and probable early stage of progression, cholangioscopic and X-ray image-guided MTC may be an alternative means of non-operative management aiming not only at palliation but also cure.Which treatment should be chosen (surgical or non-surgical) for treatment in aged patients with bile duct carcinoma whose general condition is poor remains an unresolved issue.
著者
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Andoh Hideaki
Department Of Surgery Akita University School Of Medicine
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Fukushima Takashi
Department Of Applied Chemistry Faculty Of Engineering Kansai University
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Tabuse Katsuyoshi
Depart. of Surg., National Hospital Organization Osaka Minami Medical Center
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Endoh Masaaki
Depart. of Surg., Aomori City Hosp.
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Nakadate Toshihiro
Department of Surgery, General Mizusawa Hospital
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Ino-u-e Shigeaki
Department of Surgery, Aomori Prefectural Central Hospital
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Ohsato Masayuki
Department of Surgery, Hachinohe City Hospital
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Itoh Takao
Itoh Clinic
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Shida Shoichi
Kawakami Clinic
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Nakachi Hiromichi
Ginowann Memorial Hospital
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Yoshihara Syuuichi
The 2nd Department of Surgery, Hirosaki University
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Narumi Syunnji
The 2nd Department of Surgery, Hirosaki University
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Hakamada Kennichi
The 2nd Department of Surgery, Hirosaki University
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Sasaki Mutsuo
The 2nd Department of Surgery, Hirosaki University
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Ebina Yuuichi
The 2nd Department of Surgery, Hirosaki University
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Umehara Yutaka
The 2nd Department of Surgery, Hirosaki University
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Konn Mitsuru
Emeritus Professor, Hirosaki University
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Seki Toshihito
The 3rd Department of Internal Medicine, Kannsai Medical University
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Nakadate Toshihiro
Depart. of Surg., General Mizusawa Hosp.
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Konn Mitsuru
Emeritus Prof., Hirosaki Univ.
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Ohsato Masayuki
Depart. of Surg., Hachinohe City Hosp.
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Ino-u-e Shigeaki
Depart. of Surg., National Hospital Organization Aomori Hosp.
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Nakachi Hiromichi
Ginowann Memorial Hosp.
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Andoh Hideaki
Depart. of Surg., Aomori Prefectural Central Hosp.
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Andoh Hideaki
Department of Surgery, Nakadouri General Hospital
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Seki Toshihito
The 3rd Depart. of Internal Medicine, Kannsai Medical Univ.
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Fukushima Takashi
Department of Surgery, National Hospital Organization Aomori Hospital
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Fukushima Takashi
Depart. of Surg., National Hospital Organization Aomori Hosp.
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