METHOD FOR PHOTODYNAMIC THERAPY IN THE TREATMENT OF UNRESECTABLE ADENOCARCINOMA OF EXTRAHEPATIC BILE DUCTS

摘要

FIELD: medicine; oncology.;SUBSTANCE: invention relates to medicine, namely to oncology; it can be used for photodynamic therapy (hereinafter – PDT) in the treatment of unresectable adenocarcinoma of extrahepatic bile ducts. To do this, before performing intraductal PDT, a catheter with a cylindrical diffuser is inserted into the affected bile duct. An obturator is previously removed from its distal part, X-ray negative light-optical gel is extracted from the diffuser with an injection needle with the formation of a cavity of no more than 5 mm, into which a water-soluble iodine-containing contrast agent is injected. After that, the distal part of the catheter is closed with the obturator, light guide with a direct radiation output is inserted into the proximal part of the diffuser to X-ray negative light-optical gel and further, but not more than 3 mm. After that, the hollow proximal part of the diffuser is filled with the same contrast agent. Then, external-internal cholangiodrainage is installed to a patient, the diffuser is removed along a channel formed by the drainage, introduced into bile ducts, comparing the X-ray-negative part of the diffuser with the tumor, and its targeted intraductal PDT is carried out. PDT is repeated every 8 weeks until a response to the treatment is achieved. ;EFFECT: method allows one to improve the selective delivery of laser radiation to the tumor due to its targeted uniform distribution along the circumference of walls of bile ducts, which significantly increases the efficiency of PDT.;1 cl, 1 ex