Photodynamic Therapy for Malignant Biliary Obstruction: A Case Series

Introduction

Various treatment modalities such as surgical resection, endoscopic insertion of a metal stent, and radiotherapy have been available for patients with bile duct carcinoma [1]. Elderly patients of more than 70 years of age can destroy their quality of life by selecting an inappropriate treatment for their bile duct carcinoma. Photodynamic therapy, by means of the intravenous administration of hematoporphyrin derivative and subsequent laser exposure, has been used as a local cancer therapy [2] [3] [4]. The continuous wave of the argon dye laser has been generally used in photodynamic therapy, but tissue penetrability decreases with the thermal change in the treated region. In contrast, the pulsed excimer dye laser penetrates more deeply and activates the photosensitizer more efficiently than the argon dye laser, without a thermal effect [4] [5]. Although Takeda and associates, in the Japanese literature, have reported the first application of pulsed excimer dye laser in patients with bile duct carcinoma [6], there is insufficient information on the effect of this laser system in photodynamic therapy for malignant biliary stricture.

We report the efficacy of photodynamic therapy with excimer dye laser, as a local therapy for bile duct carcinoma, in four elderly patients for whom surgery was not possible.

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