title: Volume-reserving Surgery after Photodynamic Therapy for Biliary Papillomatosis: A Case Report.
abstract: Biliary papillomatosis is rare, and its pathogenic mechanisms are not yet clear. Because of its high risk for malignancy transformation, surgical resection is regarded as a standard treatment. Photodynamic therapy (PDT) has been used by the intravenous administration of hematoporphyrin derivative followed by laser exposure. A photochemical process causes disturbance of the microvascular structure and degradation of membrane. Cholangitis is a major complication after PDT. A healthy 56-year-old man was diagnosed with biliary papillomatosis involving the common hepatic duct, both proximal intrahepatic bile ducts (IHD), and the right posterior IHD. After biliary decompression by endoscopic nasobiliary drainage, PDT was performed to avoid extensive liver resection and recurrence using endoscopic retrograde cholangiographic guidance. After portal vein embolization, the patient underwent extended right hemihepatectomy. Following administration of chemoradiation therapy with tegafur-uracil and 45 Gy due to local recurrence at postoperative 13 months, there was no local recurrence or distant metastases. This is the first case report on PDT for biliary papillomatosis in Korea. Preoperative PDT is beneficial for reducing the lesion in diffuse or multifocal biliary papillomatosis and may lead to curative and volume reserving surgery. Thus, PDT could improve the quality of life and prolong life expectation for biliary papillomatosis patients.
authors.affiliation: Departments of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chin Ock
authors.initials: CO
authors.lastname: Cheong
authors.affiliation: Departments of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Departments of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joon Seung
authors.initials: JS
authors.lastname: Park
authors.affiliation: Departments of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: Departments of Pathology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyun Ki
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Departments of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D004621:Embolization, Therapeutic; D005720:Gamma Rays; D006498:Hepatectomy; D006500:Hepatic Duct, Common / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010212:Papilloma / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D010778:Photochemotherapy; D005641:Tegafur / Q000627:therapeutic use; D014498:Uracil / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D005641:Tegafur; D014498:Uracil
keywords: Hepatectomy; Papilloma, intraducal; Photochemotherapy