In the Nebraska/Mayo transplant protocol for perihilar cholangiocarcinoma, do you ever offer prophylactic biliary drainage/stenting to prevent obstruction post-chemoradiation?
If the patient had PSC and baseline atrophy preventing brachytherapy boost (received SBRT boost instead), would this change your threshold for stenting?
Answer from: Radiation Oncologist at Community Practice
We use an ERCP-placed nasobiliary approach to biliary brachytherapy as part of our pre-transplant CRT regimen for patients with peri-hilar cholangiocarcinoma (Murad et al., PMID 22504095). Our technique is described by Deufel et al., PMID 29776892. Patients with baseline tumor and/or comorbid d...
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