TY - JOUR
T1 - Flowcharts for the management of biliary tract and ampullary carcinomas
AU - Miyakawa, Shuichi
AU - Ishihara, Shin
AU - Takada, Tadahiro
AU - Miyazaki, Masaru
AU - Tsukada, Kazuhiro
AU - Nagino, Masato
AU - Kondo, Satoshi
AU - Furuse, Junji
AU - Saito, Hiroya
AU - Tsuyuguchi, Toshio
AU - Kimura, Fumio
AU - Yoshitomi, Hideyuki
AU - Nozawa, Satoshi
AU - Yoshida, Masahiro
AU - Wada, Keita
AU - Amano, Hodaka
AU - Miura, Fumihiko
PY - 2008/1
Y1 - 2008/1
N2 - No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated type of PBM is a risk factor for gallbladder carcinoma. Symptoms that may indicate biliary tract carcinoma are jaundice and pain in the upper right area of the abdomen. The first step of diagnosis is to carry out blood biochemistry tests and ultrasonography (US) of the abdomen. The second step of diagnosis is to find the local extension of the carcinoma by means of computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP). Because resection is the only way to completely cure biliary tract carcinoma, the indications for resection are determined first. In patients with resectable disease, the indications for biliary drainage or portal vein embolization (PVE) are checked. In those with nonresectable disease, biliary stenting, chemotherapy, radiotherapy, and/or best supportive care is selected.
AB - No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated type of PBM is a risk factor for gallbladder carcinoma. Symptoms that may indicate biliary tract carcinoma are jaundice and pain in the upper right area of the abdomen. The first step of diagnosis is to carry out blood biochemistry tests and ultrasonography (US) of the abdomen. The second step of diagnosis is to find the local extension of the carcinoma by means of computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP). Because resection is the only way to completely cure biliary tract carcinoma, the indications for resection are determined first. In patients with resectable disease, the indications for biliary drainage or portal vein embolization (PVE) are checked. In those with nonresectable disease, biliary stenting, chemotherapy, radiotherapy, and/or best supportive care is selected.
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U2 - 10.1007/s00534-007-1275-9
DO - 10.1007/s00534-007-1275-9
M3 - Article
C2 - 18274839
AN - SCOPUS:39549093537
SN - 0944-1166
VL - 15
SP - 7
EP - 14
JO - Journal of Hepato-Biliary-Pancreatic Surgery
JF - Journal of Hepato-Biliary-Pancreatic Surgery
IS - 1
ER -