Percutaneous approach to the diagnosis and treatment of biliary tract malignancies.

The role of percutaneous, transhepatic management of biliary tract malignancies is to provide diagnostic and palliative care for improving patient quality of life. To treat and manage biliary tract malignancies successfully, particularly in patients who have inoperable disease, percutaneous interventions, such as biliary decompression and catheter-directed liver therapies, must be available. Although most vascular interventions do not yet commonly produce significant increased survivability in patients who have biliary tract malignancies, continued advances in percutaneous technologies suggest that future benefits in life expectancy may be achieved.

The toxicity of liver directed yttrium-90 microspheres in primary and metastatic liver tumors.

Background: Selective Internal Radiation (SIR) therapy with yttrium-90 microspheres has become an alternative approach to treat hepatic tumors.

Methods: A single institution retrospective chart review was performed to assess the safety of SIR microspheres in twenty-one patients with hepatic malignancies. The yttrium-90 radiation dose was dependent upon the percentage of tumor involvement of the liver, with a dose modification (reduction) adjusted for macroaggregated albumin (MAA) shunted to the lung.