Local Radiotherapy of Biliary Malignancies

  • M. S. Fletcher
  • D. Brinkley
  • J. L. Dawson
  • H. Nunnerley
  • Roger Williams
Conference paper


Patients presenting with obstructive jaundice due to a cholangiocarcinoma involving the hilum of the liver pose a major problem in management. Despite recent advances in preoperative assessment of resectability and in operative techniques (Blumgart 1978; Williamson et al. 1980), in most reports the rate of attempted radical curative resection has remained very low (Inouye and Whelan 1978; Akwari and Kelly 1979; Evander et al. 1980; Blumgart 1982) and the operative mortality is still 10%–20% (Lannois et al. 1979; Evander et al. 1980). In contrast, effective palliation can often be achieved with low operative mortality if the obstruction is relieved by a cholangioenteric anastamosis (Cahow 1979) or by operative insertion of a transhepatic U tube (Terblanche et al. 1972).


Obstructive Jaundice Extrahepatic Bile Duct Bile Duct Carcinoma Bile Drainage Biliary Malignancy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Akwari OE, Kelly KA (1979) Surgical treatment of adenocarcinoma: location junction of right and left and common hepatic biliary ducts. Arch Surg 114: 22 - 25PubMedGoogle Scholar
  2. Benjamin IS, McPherson GAD, Blumgart LH (1981) Iridium 192 wire for hilar cholangiocarcinoma. Lancet 11: 582 - 583CrossRefGoogle Scholar
  3. Blumgart LH (1978) Biliary tract obstruction: new approaches to old problems. Am J Surg 135: 19 - 31PubMedCrossRefGoogle Scholar
  4. Blumgart HL (1982) New perspectives and old problems in biliary surgery. Surg News 13: 1 - 4Google Scholar
  5. Cahow CE (1979) Intrahepatic cholangiojejunostomy: a new simplified approach. Am J Surg 137: 443 - 448PubMedCrossRefGoogle Scholar
  6. Dooley J, Dick R, Irving D, Olney J, Sherlock S (1981) Relief of bile duct obstruction by the percutaneous transhepatic insertion of an endoprosthesis. Clin Radiol 32: 163 - 172PubMedCrossRefGoogle Scholar
  7. Evander A, Fredlund P, Hoevels J, Ihse I, Bengmark S (1980) Evaluation of aggressive surgery for carcinoma of the extrahepatic bile ducts. Ann Surg 191: 23 — 29PubMedCrossRefGoogle Scholar
  8. Fletcher MS, Brinkley D, Dawson JL, Nunnerley H, Wheeler PG, Williams R (1981) The treatment of high bile ducts carcinoma by internal radiotherapy with iridium 192 wire. Lancet II: 172-174CrossRefGoogle Scholar
  9. Hoevels J, Lunderquist A, Ihse I (1978) Percutaneous transhepatic intubation of bile ducts for combined internal - external drainage in peroperative and palliative treatment of obstructive jaundice. Gastrointest Radiol 3: 23 - 31PubMedCrossRefGoogle Scholar
  10. Inouye AA, Whelan TJ (1978) Carcinoma of the extrahepatic bile ducts. A ten year experience in Hawaii. Am J Surg 136: 90-95Google Scholar
  11. Lamois B, Campion J-P, Brissot P (1979) Carcinoma of the hepatic hilus. Ann Surg 190: 151 - 157CrossRefGoogle Scholar
  12. Lees CD, Zapolanski A, Cooperman AM, Hermann PE (1980) Carcinoma of the bile ducts. Surg Gynaecol Obstet 151: 193 - 198Google Scholar
  13. Mornex F, Gerard J-P, Bret P, Partensky P (1981) Iridium wire radiotherapy for high bile duct carcinoma. Lancet 11: 479CrossRefGoogle Scholar
  14. Nakayama T, Ikeda A, Okukda K (1978) Percutaneous transhepatic drainage of the biliary tract. Gastroenterology 74: 554 - 559PubMedGoogle Scholar
  15. Pollock TW, Ring ER, Oleaga JA, Freiman DB, Müllen JL, Rosato EF (1979) Percutaneous decompression of benign and malignant biliary obstruction. Arch Surg 114: 148 - 151PubMedGoogle Scholar
  16. Terblanche J, Saunders SJ, Louw JH (1972) Prolonged palliation in carcinoma of the main hepatic duct junction. Surgery 71: 720 — 731PubMedGoogle Scholar
  17. Wheeler PG, Dawson JL, Nunnerley H, Brinkley D, Laws J, Williams R (1981) Newer techniques in the diagnosis and treatment of proximal bile duct carcinoma - an analysis of 41 consecutive cases. Q J Med 50: 247 - 259PubMedGoogle Scholar
  18. Williamson BWA, Blumgart LH, McKellar NJ (1980) The management of tumours of the liver. Am J Surg 139: 210 - 215PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • M. S. Fletcher
  • D. Brinkley
  • J. L. Dawson
  • H. Nunnerley
  • Roger Williams

There are no affiliations available

Personalised recommendations