Application of endoscopic microwave coagulation to the treatment of lower bile duct carcinoma

Abstract

Endoscopic microwave coagulation therapy (EMCT) was successfully applied to female patients aged 79 and 82 with obstructive jaundice due to lower bile duct carcinoma, because of their refusal pancreatoduodenectomy (PD). A single 10-second exposure of microwave (50 W,2450 MHz) was delivered 15 to 20 times during each treatment to the cancerous tissue using a monopoler shielded wire electrode under guidance of a percutaneous cholangioendoscopy. Treatment was repeated a total of three or six times at intervals of 1 week, and an expandable metallic stent was plased after recanalization of bile duct and negative tests for cancer cells. Supplementary radiation therapy (50.4 Gy) was performed after EMCT, and no complications were encountered. Patients have subsequently lived well for 12 and 11 months without jaundice. These results indicate that EMCT for patients with lower bile duct cancer and high operative rick might be an effective alternative for PD.