Clinical Endoscopy

Current Status of Photodynamic Therapy for Bile Duct Cancer: Tae Yoon Lee, Young Koog Cheon, Chan Sup Shim; Clin Endosc 2013;46(1):38-44. Published online January 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.1.38

The most common form in bile duct cancers is a highly desmoplastic cancer with a growth pattern characterized by periductal extension and infiltration. The prognosis of bile duct cancers, especially hilar cholangiocarcinoma, is limited by tumor spread along the biliary tree leading to refractory obstructive cholestasis, cholangitis, and liver failure. Although biliary endoprosthesis improves occlusion rates and reduces the number of therapeutic interventions, median survival time is not ameliorated. Photodynamic therapy (PDT) is a local photochemical tumor treatment that consists of a photosensitizing agent in combination with laser irradiation of a distinct wavelength. Tumor ablation with PDT combined with biliary stenting reduces cholestasis and significantly improves median survival time in selected patients with bile duct cancers.

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내시경적 제거가 어려운 총담관 결석 환자에서 담도배액술 후의 경과 관찰: Korean J Gastrointest Endosc 2003;27(5):427-427. Published online November 20, 2003

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증례 : 식도 위장관 ; Plummer - Vinson 증후군의 내시경적 풍선확장술 치험 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Plummer - Vinson Syndrome Treated with Endoscopic Balloon Dilatation ): Korean J Gastrointest Endosc 1998;18(1):61-65. Published online November 30, 1997

Abstract PDF: Plummer-Vinson syndrome is characterized by dysphagia associated with anemia, glossitis and esophageal web. The cause of this syndrome is still not clear, but the most important one is thought to be the iron deficiency. The patient with small sized ageal web is treated by administration of iron but large sized web with dyspha gia requires breakage of web. In the following case report, we describe a patient with Plummer-Vinson syndrome who showed clinical improvement after treatmeat with endoscopic balloon dilatation of upper esophageal web with a review of literatures. (Korean J Gastrointest Endosc 18: 61-65, 1998)

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원저 : 담도 췌장 ; Modified Gianturco Z 담도배액관을 이용한 ERBD 법 ( Original Articles : Biliary Tract & Pancreas ; Endoscopic Application of Modified Gianturco Z Biliary Stent ): Korean J Gastrointest Endosc 1998;18(1):51-59. Published online November 30, 1997

Abstract PDF: Palliative treatment of malignant biliary obstructions represent the principal indications of endoscopic or percutaneous transhepatic implantation of endoprostheses. Many kinds of biliary stents have been used to maintain patency of the bile ducts obstructed by benign or malignant strictures. However, the biliary stent in current use, has a tendency to become blocked. In order to maintain a long-term stent patency before clogging, biliary stents with large diameters are needed and some kinds of expandable metal stents are proposed. The Hanaro stent(Sooho medi-tech Co. LTD, Seoul, Korea) is a modified Gianturco Z biliary stent, made of 0,01-inch stainless steel wire with a zigzag pattern. It has a spiral, cylindrical configuration and is 10 mm in expanded diameter. It hes been used only with the percutaneous transhepatic technique. In this article, we describe a new method for endoscopic retrograde placement of a modified Gianturco Z biliary stent. This report describes our experience on endoscopic application of a modified Gianturco Z biliary stent in a patient with malignant obstruction of the distal common bile duct. (Korean J Gastrointest Endosc 18: 51-57, 1998)

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증례 : 식도 위장관 ; 양잿물에 의한 식도협착에서 식도풍선확장술과 일시적 EsophaCoilTM 인공식도관 삽관술의 병합요법 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Esophageal Stricture by Lye that Treated with Esophageal Endoscopic Endoprosthesis ): Korean J Gastrointest Endosc 1996;16(6):963-968. Published online November 30, 1995

Abstract PDF: Swallowing caustic materials may produce full-thickness burn and loss of esophageal function. Caustics, both acid and alkalis, can corrode and destroy living tissue. Full-thickness burn of esophiageal epithelium causes severe stricture which frequently requires surgical repair. Recently, non-operative dilatation of luminal stenosis has been utilized. Esophageal endoscopic endoprosthesis has been used widely in malignant esophageal stricture but not in benign stricture. In recurrent benign esophageal stricture following repetitive balloon dilatation, we experienced a case of an 18-year old woman with severe stricture which was successfully managed by esophageal endoprosthesia So we report this case with the review of the literature. (Korean J Gastrointest Endosc 16: 963~968, 1996)

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증례 : 식도 위장관 ; 악성 식도협착에서의 금속제 확장형 Wallstent 인공식도삽관술 ( Case Reports : Esophagus , Stomach & Intestine ; Self - expanding Wallstent for Palliative Treatment of Malignant Esophageal Stenosis ): Korean J Gastrointest Endosc 1995;15(4):704-711. Published online November 30, 1994

Abstract PDF: The main objective of palliative treatment of malignant esophageal stenosis is rapid restoration of passage of fluid and solids. Endoscopic intubation with plastic endoprosthesis may lead to prompt relief of dysphagia and is a effective procedure for the palliative treatment of malignant esophageal stenosis. However, the insertion procedure, which necessitates prior dilatation, is traumatic and associated with considerable risk for perforation and bleeding. Tumor overgrowth, stent migration and stent blockage are frequent complications. Recently, self expanding metal stents woven in the form of tubular mesh made from surgical grade stainless steel alloy filaments(Wallstent), have been developed to offer possible advatage over conventional plastic tubes. The small diameter of introducer system carrying the compressed stent(18Fr) allows a relatively easy insertion procedure that dose not require prior dilatation. This stent is pliable. self-expanding and flexible in the longitudinal axis. We experienced a case of a 74-year-old male with malignant esophageal stenosis in whom self-expanding Wallstent was implanted with successful oral nutrition and much improvement of dysphagia. (Kor J Gastrointest Endosc 15: 704-709, 1995)

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증례 : 악성 식도협착에서의 금속제 확장형 EsophaCoilTM 인공식도삽관술 ( Case Reports : Self - Expanding EsophaCoilTM Esophageal Prosthesis for Malignant Esophageal Stenosis ): Korean J Gastrointest Endosc 1995;15(1):63-71. Published online November 30, 1994

Abstract PDF: Endoscopic endoprosthesis is well established as a cheap, fast and durable procedure for palliation of malignant dysphagia. But the placement of conventional endoprosthesis is difficult and is associated with significant complications such as hemorrhage, perforation and dysfunction of the prosthesis. Recently, self -expand- able metal prosthesis have also been utilized for malignant esophageal stenosis, and palliation of this modality seems to be more effective than other modalities. However the main problems with these metal stents are tumor ingrowth leading to reobstruction, migration, and eophageal trauma by the distal, hard skirt of the stent. EsophaCoil stent is a simple coil with close loops made from a single flat wire of nickel titanium alloy. The radial force of this material is much stronger than stainless steel, expansion time is faster and the stent is able to dilate even extremely resistant strictures. This new metalic stent seems to have several advantages over the current commnerically available ones. We report our experiences with this EsophaCoil stent and review of literature.

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내시경적 담도배액법 ( EBD ) 후 발생한 십이지장 천공 1예 ( A Case of Duodenal Perforation following Endoscopic Biliary Drainage ( EBD ) ): Korean J Gastrointest Endosc 1992;12(1):91-97. Published online November 30, 1991

Abstract PDF: Placement of an endoprosthesis for palliative decompression of biliary obstruction has been advocated as an effective alternative for interanl-external drainage catheters, of which the care and psychological impact of the external segment protruded through the skin has been a difficult problem. (continue...)

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