[The surgical and alternative treatment potentials in biliary tract cancer. II. Alternative potentials]

The modern diagnosis of biliary tract cancer is still unsatisfactory regardless of the introduction of updated instrumental diagnostic methods. The latter may undergo development and transformation into therapeutic procedures. Patients with increased operative risk, and those presenting locally intractable neoplasm or metastases are indicated for this kind of alternative therapeutic approach. Experience had with endoscopic treatment of 89 patients with cancer of the biliary apparatus is shared. In forty of them (45 per cent) treatment with endoscopic papillotomy, prosthetic replacement or pernasal drainage proves successful. The procedure runs the hazards of early and late complications. Survivorship is prolonged by six months average, maximum 23 months. In eight cases permanent percutaneous (external) biliary drainage is undertaken as a final palliative measure, contributing to survival ranging from 1 to 3 months. In conclusion, the alternative methods have an actual place in the armamentarium of treatment procedures for this contingent of oncological patients.