Flowcharts for the management of biliary tract and ampullary carcinomas

Journal of Hepato-Biliary-Pancreatic Surgery

Volumn 15, Issue 1, 2008, Pages 7-14

  Miyakawa, Shuichi ^a   Ishihara, Shin ^a   Takada, Tadahiro ^b   Miyazaki, Masaru ^c   Tsukada, Kazuhiro ^d   Nagino, Masato ^e   Kondo, Satoshi ^f   Furuse, Junji ^g   Saito, Hiroya ^h   Tsuyuguchi, Toshio ^c   Kimura, Fumio ^c   Yoshitomi, Hideyuki ^c   Nozawa, Satoshi ^c   Yoshida, Masahiro ^b   Wada, Keita ^b   Amano, Hodaka ^b   Miura, Fumihiko ^b  

^a FUJITA HEALTH UNIVERSITY   (Japan)

^b TEIKYO UNIVERSITY SCHOOL OF MEDICINE   (Japan)

^c CHIBA UNIVERSITY GRADUATE SCHOOL OF MEDICINE   (Japan)

^d UNIVERSITY OF TOYAMA   (Japan)

^e NAGOYA UNIVERSITY GRADUATE SCHOOL OF MEDICINE   (Japan)

^f HOKKAIDO UNIVERSITY GRADUATE SCHOOL OF MEDICINE   (Japan)

^g NATIONAL CANCER CENTER HOSPITAL EAST   (Japan)

^h Asahikawa Kosei Hospital   (Japan)

Author keywords

Ampullary carcinoma; Bile duct carcinoma; Biliary tract carcinoma; Gallbladder carcinoma; Guidelines

Indexed keywords

GEMCITABINE;

ABDOMINAL PAIN; ALGORITHM; ARTICLE; BILE DUCT CARCINOMA; BILIARY TRACT DRAINAGE; BILIARY TRACT SURGERY; BIOCHEMISTRY; CANCER CHEMOTHERAPY; CANCER DIAGNOSIS; CANCER RADIOTHERAPY; CHEMOEMBOLIZATION; CLINICAL PROTOCOL; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; COMPUTER ASSISTED TOMOGRAPHY; ECHOGRAPHY; ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY; EVIDENCE BASED MEDICINE; GALLBLADDER CARCINOMA; HUMAN; JAUNDICE; MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY; NUCLEAR MAGNETIC RESONANCE IMAGING; PANCREATICODUODENECTOMY; PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY; PHOTODYNAMIC THERAPY; PORTAL VEIN; PREOPERATIVE CARE; PRIMARY SCLEROSING CHOLANGITIS; RISK FACTOR; STENT; SYMPTOM; VATER PAPILLA CARCINOMA;

ALGORITHMS; AMPULLA OF VATER; BILIARY TRACT NEOPLASMS; CARCINOMA; HUMANS; RISK FACTORS;

EID: 39549093537     PISSN: 09441166     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00534-007-1275-9     Document Type: Article

References (100)

1. Takada T, Miyazaki M, Miyakawa S, Tsukada K, Nagino M, Kondo S, et al. Purpose, use, and preparation of clinical practice guidelines for the management of biliary tract and ampullary carcinomas. J Hepatobiliary Pancreat Surg 2008;15:2-6.
2. Tashiro S, Imaizumi T, Ohkawa H, Okada A, Katoh T, Kawarada Y, et al. Pancreaticobiliary maljunction: Retrospective and nationwide survey in Japan. J Hepatobiliary Pancreat Surg 2003;10:345-51.
3. Rosen CB, Nagorney DM, Wiesner RH, Coffey RJ Jr, Larusso NF. Cholangiocarcinoma complicating primary sclerosing cholangitis. Ann Surg 1991; 213:21-5.
4. Rosen CB, Nagorney DM. Cholangiocarcinoma complicating primary sclerosing cholangitis. Semin Liver Dis 1991;11:26-30.
5. Callea F, Sergi C, Fabbretti G, Brisigotti M, Cozzutto C, Medicina D. Precancerous lesions of the biliary tree. J Surg Oncol Suppl 1993;3:131-3.
6. Franco J, Saeian K. Biliary tract inflammatory disorders, primary sclerosing cholangitis and primary biliary cirrhosis. Curr Gastroenterol Rep 1999;1:95-101.
7. Thuluvath PJ, Rai R, Venbrux AC, Yeo CJ. Cholangiocarcinoma: A review. Gastroenterologist 1997;5:306-15.
8. Yeo CJ, Pitt HA, Cameron JL. Cholangiocarcinoma. Surg Clin N Am 1990;70:1429-47.
9. Sugiyama M, Atomi Y, Kuroda A, Muto T. Bile duct carcinoma without jaundice: Clues to early diagnosis. Hepatogastroenterology 1997;44:1477-83.
10. Malik IA. Clinicopathological features and management of gallbladder cancer in Pakistan: A prospective study of 233 cases. J Gastroenterol Hepatol 2003;18:950-3.
11. Al-Quadah MS, Daradkeh S, Sroujieh AS, Farah GR, Masaad J. Gallbladder carcinoma in Jordan. Hepatogastroenterology 2005;61:5-7.
12. Nieveen Van Dijkum EJ, Terwee CB, Oosterveld P, Van Der Meulen JH, Gouma DJ, De Haes JC. Validation of the gastrointestinal quality of life index for patients with potentially operable periampullary carcinoma. Br J Surg 2000;87:110-5.
13. Kamisawa T, Tu Y, Egawa N, Nakajima H, Horiguchi S, Tsuruta K, et al. Clinicopathologic features of ampullary carcinoma without jaundice. J Clin Gastroenterol 2006;40:162-6.
14. de Groen PC, Gores GJ, LaRusso NF, Gunderson LL, Nagorney DM. Biliary tract cancers. New Engl J Med 1999;341:1368-79.
15. Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet 2005; 366:1303-14.
16. Misra S, Chaturvedi A, Misra NC, Sharma ID. Carcinoma of the gallbladder. Lancet Oncol 2003;4:167-76.
17. Piantino P, Fusaro A, Randone A, Cerchier A, Daziano E. Increased levels of CA19-9, CA50 and CA125 in patients with benign disease of biliary tract and the pancreas. J Nucl Med Allied Sci 1990;34-97.
18. Patel AH, Harnois DM, Klee GG, LaRusso NF, Gores GJ. The utility of CA 19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis. Am J Gastroenterol 2000;95:204-7.
19. Nichols JC, Gores GJ, LaRusso NF, Wiesner RH, Nagorney DM, Ritts RE Jr. Diagnostic role of serum CA 19-9 for cholangiocarcinoma in patients with primary sclerosing cholangitis. Mayo Clin Proc 1993;68:874-9.
20. Khan SA, Davidson BR, Goldin R, Pereira SP, Rosenbera WM, Taylor-Robinson SD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: Consensus document. Gut 2002;51:1-9.
21. Pasanen PA, Eskelinen M, Partanen K, Pikkarainen P, Pentillä I, Alhava E. Clinical value of serum tumor markers CEA, CA50 and CA242 in the distinction between malignant versus benign diseases causing jaundice and cholestasis; results from a prospective study. Anticancer Res 1992;12:1687-93.
22. Han JK, Choi BI, Kim AY, An SK, Lee JW, Kim TK, et al. Cholangiocarcinoma: Pictorial essay of CT and cholangiographic findings. Radiographics 2002;22:173-87.
23. Khan SA, Davidson BR, Goldin R, Pereria SP, Rosenbera WM, Taylor-Robinson SD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: Consensus document. Gut 2002;51:1-9.
24. Chen HW, Pan AZ, Zhen ZJ, Su SY, Wang JH, Yu SC, et al. Preoperative evaluation of resectability of Klatskin tumor with 16-MDCT angiography and cholangiography. AJR Am J Roentgenol 2006;186:1580-6.
25. Lopera JE, Soto JA, Munera F. Malignant hilar and perihilar biliary obstruction: Use of MR cholangiography to define the extent of biliary ductal involvement and plan percutaneous interventions. Radiology 2001;220:90-6.
26. Romagnuolo J, Bardou M, Rahme E, Joseph L, Reinhold C, Barkun AN. Magnetic resonance cholangiopancreatography: A meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003;139:547-57.
27. Barish MA, Yocel EK, Ferrucci JT. Magnetic resonance cholangiopancreatography. New Engl J Med 1999;341:258-64.
28. Park MS, Kim TK, Kim KW, Perk SW, Lee JK, Kim JS, et al. Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: findings at MRCP versus ERCP. Radiology 2004;233:234-40.
29. Sakamoto E, Nimura Y, Hayakawa N, Kamiya J, Kondo S, Nagino M, et al. The pattern of infiltration at the proximal border of hilar bile duct carcinoma: A histologic analysis of 62 resected cases. Ann Surg 1998;227:405-11.
30. Hayashi S, Miyazaki M, Kondo Y, Nakajima Nl. Invasive growth patterns of hepatic hilar ductal carcinoma. A histologic analysis of 18 surgical cases. Cancer 1994;73:2922-9.
31. Takada T, Hanyu F, Kobayashi S, Mikoshiba Y, Hamano K. Percutaneous transhepatic cholangiodrainage and cholangioscopy for the case of severe obstructive jaundice caused by pancreatic tumor. In: Stefanini P, Speranza V, editors. Proceedings of the 18th World Congress of the Int Coll Surg. New York: Excerpta Medica Amsterdam American Elsevier; 1973.
32. Nimura Y, Kamiya J, Hayakawa N, Shionoya S. Cholangioscopic differentiation of biliary strictures and polyps. Endoscopy 1989;21 (Suppl 1):351-6.
33. Nimura Y. Staging of biliary carcinoma: Cholangiography and cholangioscopy. Endoscopy 1993;25:76-80.
34. Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T, Ishii K, et al. Peroral cholangioscopic diagnosis of biliary-tract diseases by using narrow-band imaging (with videos). Gastrointest Endosc 2007;66:730-6.
35. Fukuda Y, Tsuyuguchi T, Sakai Y, Tsuchiya S, Saisyo H. Diagnostic utility of peroral cholangioscopy for various bile-duct lesions. Gastrointest Endosc 2005;62:374-82.
36. Sugiyama M, Atomi Y, Yamato T. Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions: Analysis in surgical and follow up series. Gut 2000;46:250-4.
37. Azuma T, Yoshikawa T, Araida T, Takasaki K. Differential diagnosis of polypoid lesion of the gallbladder by endoscopic ultrasonography. Am J Surg 2001;181:65-70.
38. Hirooka Y, Naitoh Y, Goto H, Ito A, Hayakawa S, Watanabe Y, et al. Contrast-enhanced endoscopic ultrasonography in gallbladder diseases. Gastrointest Endosc 1998;48:406-10.
39. Furukawa H, Kosuge T, Shimada K, Yamamoto J, Kanai Y, Mukai K, et al. Small polypoid lesions of the gallbladder. Arch Surg 1998;133:735-9.
40. Kumaran V, Gulati S, Paul B, Pande K, Sahni P, Chattopadhyay K. The role of dual-phase helical CT in assessing resectability of carcinoma of the gallbladder. Eur Radiol 2002;12:1993-9.
41. Kim JH, Kim TK, Eun HW. Preoperative evaluation of gallbladder carcinoma: Efficacy of combined use of MR imaging, MR cholangigraphy, and contrast-enhanced dual phase three dimensional MR angiography. J Magn Reson Imaging 2002;16:676-84.
42. Schwartz LH, Black J, Fong Y, Jarnagin W, Blumgart L, Gruen D, et al. Gallbladder carcinoma: Findings at MR imaging with MR cholangiopancreatography. J Comput Assist Tomogr 2002;26:405-10.
43. Menzel J, Hoepffner N, Sulkowski U, Reimer P, Heinecke A, Poremba C, et al. Polypoid tumors of the major duodenal papilla: Preoperative staging with intraductal US, EUS, and CT-a prospective, histopathologically controlled study. Gastrointest Endosc 1999;49:349-57.
44. Itoh A, Goto H, Naitoh Y, Hirooka Y, Furukawa T, Hayakawa Tl. Intraductal ultrasonography in diagnosing tumor extension of cancer of the papilla of Vater. Gastrointest Endosc 1997;45:251-60.
45. Weber SM, DeMatteo RP, Fong Y, Blumgart LH, Jarnagin WR. Staging laparoscopy in patients with extrahepatic biliary carcinoma. Analysis of 100 patients. Ann Surg 2002;235:392-9.
46. Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 2000;87:418-22.
47. Shimada H, Endo I, Togo S, Nakano A, Izumi T, Nakagawara G. The role of lymph node dissection in the treatment of gallbladder carcinoma. Cancer 1997;79:892-9.
48. Nishio H, Nagino M, Ebata T, Yokoyama Y, Igami T, Nimura Y. Aggressive surgery for stage IV gallbladder carcinoma; what are the contraindications? J Hepatobiliary Pancreat Surg 2007;14:351-7.
49. Kitagawa Y, Nagino M, Kamiya J, Uesaka K, Sano T, Yamamoto H, et al. Lymph node metastasis from hilar cholangiocarcinoma: Audit of 110 patients who underwent regional and paraaortic node dissection. Ann Surg 2001;233:385-92.
50. Poveski SP, Karpeh MS Jr, Conlon KC, Blumgart LH, Brennan MF. Association of preoperative biliary drainage with postoperative outcome following pancreatoduodenestomy. Ann Surg 1999;230:131-42.
51. Sewnath ME, Birjmohum RS, Rauws EA, Heiberegtes K, Obertop H, Gouma DJ. The effect of preoperative biliary drainage on postoperative complications after pancreatoduodenectomy. J Am Coll Surg 2001;192:726-34.
52. Martignoni ME, Wabner M, Krähhenbühl L, Redaelli CA, Friess H, Bücher MW. Effect of preoperative biliary drainage on surgical outcome after pancreatoduodenectomy. Am J Surg 2001;181:52-9.
53. Pisters PW, Hudec WA, Hess KR, Lee JE, Vauthey JN, Lahoti S, et al. Effect of preoperative biliary decompression on pancreatoduodenectomy. Associated morbidity in 300 consecutive patients. Ann Surg 2001;234:47-55.
54. Takada T. Is preoperative biliary drainage necessary according to evidence-based medicine? J Hepatobiliary Pancreat Surg 2001;8:58-64.
55. Nagino M, Kamiya J, Uesaka K, Sano T, Yamamoto H, Hayakawa K, et al. Complications of hilar cholangiocarcinoma. World J Surg 2001;25:1277-83.
56. Farges O, Belghiti J, Kianmanesh R, Regimbeau JM, Santoro R, Vilgrain V, et al. Portal vein embolization before right hepatectomy: Prospective clinical trial. Ann Surg 2003;237:208-17.
57. Hemming AW, Reed AI, Fujita S, Foley DP, Howard RJ. Surgical management of hilar cholangiocarcinoma. Ann Surg 2005; 241:693-9.
58. Seyama Y, Kubota K, Sano K, Noie T, Takayama T, Kosuge T, et al. Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate. Ann Surg 2003;238:73-83.
59. Kawasaki S, Imamura H, Kobayashi A, Noike T, Miwa S, Miyagawa S. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization. Ann Surg 2003;238:84-92.
60. Kondo S, Hirano S, Ambo Y, Tanaka E, Okushiba S, Morikawa T, et al. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins: Results of a prospective study. Ann Surg 2004;240:95-101.
61. Sano T, Shimada K, Sakamoto Y, Yamamoto J, Yamasaki S, Kosuge T. One hundred two consecutive hepatobiliary resections for perihilar cholangiocarcinoma with zero mortality. Ann Surg 2006;244:240-7.
62. Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: Surgical outcome and long-term follow-up. Ann Surg 2006;243:364-72.
63. Nimura Y, Hayakawa N, Kamiya J, Kondo S, Shionoya S. Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus. World J Surg 1990;14:535-43.
64. Gazzaniga GM, Filauro M, Bagarolo C, Mori L. Surgery for hilar cholangiocarcinoma: Italian experience, J Hepatobiliary Pancreat Surg 2000;7:122-7.
65. Lee SG, Lee YJ, Park KM, Hwang S, Min PC. One hundred and eleven liver resections for hilar bile duct cancer. J Hepatobiliary Pancreat Surg 2000;7:135-41.
66. Su CH, Tsay SH, Wu CC, Shyr YM, King KL, Lee CH, et al. Factors influencing postoperative morbidity, mortality, and survival after resection for hilar cholangiocarcinoma. Ann Surg 1996;223:384-94.
67. Kayahara M, Nagakawa T, Ohta T, Kitagawa H, Tajima H, Miwa K. Role of nodal involvement and the periductal soft-tissue margin in middle and distal bile duct cancer. Ann Surg 1999; 229:76-83.
68. Jang JY, Kim SW, Park DJ, Ahn YJ, Yoon YS, Choi MG, et al. Actual long-term outcome of extrahepatic bile duct cancer after surgical resection. Ann Surg 2005;241:77-84.
69. Ebata T, Watanabe H, Ajioka Y, Oda K, Nimura Y. Pathological appraisal of lines of resection for bile duct carcinoma. Br J Surg 2002;89:1260-7.
70. Ebata T, Nagino M, Kamiya J, Uesaka K, Nagasaka T, Nimura Y. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: Audit of 52 consecutive cases. Ann Surg 2003;238:720-7.
71. Miyazaki M, Kato A, Ito H, Kimura F, Shimizu H, Ohtsuka M, et al. Combined vascular resection in operative resection for hilar cholangiocarcinoma: Does it work or not? Surgery 2007;141:581-8.
72. Suzuki T, Yoshidome H, Kimura F, Shimizu H, Ohtsuka M, Kato A, et al. Renal function is well maintained after use of left renal vein graft for vascular reconstruction in hepatobiliary-pancreatic surgery. J Am Coll Surg 2006;202:87-92.
73. Hemming AW, Kim RD, Mekeel KL, Fujita S, Reed AI, Foley DP, et al. Portal vein resection for hilar cholangiocarcinoma. Am Surg 2006;72:599-604; discussion 604-5.
74. Nimura Y, Hayakawa N, Kamiya J, Maeda S, Kondo S, Yasui A, et al. Combined portal vein and liver resection for carcinoma of the biliary tract. Br J Surg 1991;78:727-31.
75. Miyazaki M, Itoh H, Ambiru S, Shimizu H, Togawa A, Gohchi E, et al. Radical surgery for advanced gallbladder carcinoma. Br J Surg 1996;83:478-81.
76. Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Extensive surgery for carcinoma of the gallbladder. Br J Surg 2002;89:179-84.
77. Klein P, Reingruber B, Kastl S, Dworak O, Hohenberger W. Is local excision of pT1-ampullary carcinomas justified?. Eur J Surg Oncol 1996; 22:366-71.
78. Paramythiotis D, Kleeff J, Wirtz M, Friess H, Büchler MW. Still any transduodenal local excision in tumors of the papilla of Vater? J Hepatobiliary Pancreat Surg 2004;11:239-44.
79. Beger HG, Treitschke F, Gansauge F, Harada N, Hiki N, Mattfeldt T. Tumor of the ampulla of Vater. Arch Surg 1999;134: 526-32.
80. Todoroki T, Iwasaki Y, Orii K, Otsuka M, Ohara K, Kawamoto T, et al. Resection combined with intraoperative radiation therapy (IORT) for stage IV (TNM) gallbladder carcinoma. World J Surg 1991;15:357-66.
81. Todoroki T, Kawamoto T, Otsuka M, Koike N, Yoshida S, Takada Y, et al. Benefits of combining radiotherapy with aggressive resection for stage IV gallbladder cancer. Hepatogastroenterology 1999;46:1585-91.
82. González González D, Gerard JP, Maners AW, De la Lande-Guyaux B, Van Dijk-Milatz A, et al. Results of radiation therapy in carcinoma of the proximal bile duct (Klatskin tumor). Semin Liver Dis 1990;10:131-41.
83. Langer JC, Langer B, Taylor BR, Zeldin R, Cummings B. Carcinoma of the extrahepatic bile ducts: Results of an aggressive surgical approach. Surgery 1985;98:752-9.
84. Stein DE, Heron DE, Rosato EL, Anne PR, Topham AK. Positive microscopic margins alter outcome in lymph node-negative cholangiocarcinoma when resection is combined with adjuvant radiotherapy. Am J Clin Oncol 2005;28:21-3.
85. Speer AG, Cotton PB, Russell RC, Mason RR, Hatfield AR, Leung JW, et al. Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet 1987;2:57-62.
86. Smith AC, Dowsett JF, Russell RC, Hatfield AR, Cotton PB. Randomised trial of endoscopic stenting versus surgical bypass in malignant low bile duct obstruction. Lancet 1994;344:1655-60.
87. Davids PH, Groen AK, Rauws EA, Tytgat GN, Huibregtse K. Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet 1992;340:1488-92.
88. Kaassis M, Boyer J, Dumas R, Ponchon T, Coumaros D, Delcenserie R, et al. Plastic or metal stents for malignant stricture of the common bile duct? Results of a randomized prospective study. Gastrointest Endosc 2003;57:178-82.
89. Levy MJ, Baron TH, Gostout CJ, Petersen BT, Farnell MB. Palliation of malignant extrahepatic biliary obstruction with plastic versus expandable metal stents: An evidence-based approach. Clin Gastroenterol Hepatol 2004;2:273-85.
90. Hausegger KA, Thurnher S, Bodendörfer G, Zollikofer CL, Uggowitzer M, Kugler C, et al. Treatment of malignant biliary obstruction with polyurethane-covered Wallstents. AJR Am J Roentgenol 1998;170:403-8.
91. Isayama H, Komatsu Y, Tsujino T, Sasahira N, Hirano K, Toda N, et al. A prospective randomised study of "covered" versus "uncovered" diamond stents for the management of distal malignant biliary obstruction. Gut 2004;53:729-34.
92. Wagner HJ, Knyrim K, Vakil N, Klose KJ. Plastic endoprostheses versus metal stents in the palliative treatment of malignant hilar biliary obstruction. A prospective and randomized trial. Endoscopy 1993;25:213-6.
93. Glimelius B, Hoffman K, Sjödén PO, Jacobsson G, Sellström H, Enander LK, et al. Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol 1996;7:593-600.
94. Takada T, Nimura Y, Katoh H, Nagakawa T, Nakayama T, Matsushiro T, et al. Prospective randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C for nonresectable pancreatic and biliary carcinoma: multicenter randomized trial. Hepatogastroenterology 1998;45:2020-6.
95. Ishii H, Furuse J, Yonemoto N, Nagase M, Yoshino M, Sato T. Chemotherapy in the treatment of advanced gallbladder cancer. Oncology 2004;66:138-42.
96. Okusaka T, Ishii H, Funakoshi A, Yamao K, Ohkawa S, Saito S, et al. Phase II study of single-agent gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol 2006;57:647-53.
97. Grove MK, Hermann RE, Vogt DP, Broughan TA. Role of radiation after operative palliation in cancer of the proximal bile ducts. Am J Surg 1991;161:454-8.
98. Tollenaar RA, van de Velde CJ, Taat CW, Gonzalez Gonzalez D, Leer JW, Hermans J. External radiotherapy and extrahepatic bile duct cancer. Eur J Surg 1991;157:587-9.
99. Ortner ME, Caca K, Berr F, Liebetruth J, Mansmann U, Huster D, Voderholzer W, et al. Successful photodynamic therapy for nonresectable cholangiocarcinoma: A randomized prospective study. Gastroenterology 2003;125:1355-63.
100. Zoepf T, Jakobs R, Arnold JC, Apel D, Riemann JF. Palliation of nonresectable bile duct cancer: Improved survival after photodynamic therapy. Am J Gastroenterol 2005;100:2426-30.