Cholangiocarcinoma is the primary
malignancy arising from the biliary epithelium, and it presents as
jaundice,
cholestasis, and
cholangitis. Over 50 percent of patients present with advanced-stage disease, and the prognosis is poor with the survival measured in months even after biliary
decompression. Palliative management has become the standard of care for unresectable disease, and this involves an endoscopic approach.
Photodynamic therapy (
PDT) involves the administration of a
photosensitizer followed by local irradiation with
laser therapy. The use of
PDT for palliation of bile-duct
tumors has produced promising results. Several studies conducted in Europe and the United States have shown that
PDT produces a marked improvement in the symptoms of
cholestasis, survival, and quality of life. This chapter summarizes the principle of
PDT, the technique employed, and the published experience regarding
PDT for
cholangiocarcinoma.