Dersleri yüzünden oldukça stresli bir ruh haline sikiş hikayeleri bürünüp özel matematik dersinden önce rahatlayabilmek için amatör pornolar kendisini yatak odasına kapatan genç adam telefonundan porno resimleri açtığı porno filmini keyifle seyir ederek yatağını mobil porno okşar ruh dinlendirici olduğunu iddia ettikleri özel sex resim bir masaj salonunda çalışan genç masör hem sağlık hem de huzur sikiş için gelip masaj yaptıracak olan kadını gördüğünde porn nutku tutulur tüm gün boyu seksi lezbiyenleri sikiş dikizleyerek onları en savunmasız anlarında fotoğraflayan azılı erkek lavaboya geçerek fotoğraflara bakıp koca yarağını keyifle okşamaya başlar
Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma | OMICS International | Abstract
ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
Open Access

Like us on:

Our Group organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations
700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Review Article

Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma

Varayu Prachayakul*

Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

*Corresponding Author:
Varayu Prachayakul
Siriraj GI Endoscopy Center
Division of Gastroenterology
Department of Internal Medicine
Faculty of Medicine
Siriraj Hospital, Mahidol University, Bangkok
Thailand 10700
Tel: +66818654646
Fax: +6624121088
E-mail: [email protected]

Received date: January 03, 2014; Accepted date: January 27, 2014; Published date: February 06, 2014

Citation: Prachayakul V (2014) Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma. J Gastroint Dig Syst 4:168. doi:10.4172/2161-069X.1000168

Copyright: © 2014 Prachayakul V. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Cholangiocarcinoma is a high-mortality primary hepatic malignancy. A higher incidence of cholangiocarcinoma was reported in Asia, especially Southeast Asia, than in Western countries. Hilar cholangiocarcinoma is a specific type of extrahepatic cholangiocarcinoma that involves the hepatic hilum and has a worse prognosis. More than half of the patients with jaundice are inoperable at the time of first diagnosis. Therefore, biliary drainage is the mainstay of palliative treatment in these patients. Endoscopic biliary drainage via endoscopic retrograde cholangiopancreatography, the modality of choice, for the advanced hilar type is more difficult and complex than those in distal cholangiocarcinoma. Endoscopists should consider many factors before selecting the most appropriate treatment for each patient. Here we discuss the factors systematically. In cases of transpapillary approach failure, other therapeutic modalities should be considered. Percutaneous transhepatic biliary drainage is the most popular method in such cases. At the present, endoscopic ultrasound-guided biliary drainage, especially hepaticogastrostomy, is an alternative procedure with the same efficacy and low complications when it was carried out in the expert hands. Furthermore, recent locoregional therapies for tumor control including trans-luminal photodynamic therapy and radiofrequency ablation also benefit these patients.


Google Scholar citation report
Citations : 1499

Journal of Gastrointestinal & Digestive System received 1499 citations as per Google Scholar report

Journal of Gastrointestinal & Digestive System peer review process verified at publons
Indexed In
  • Index Copernicus
  • Google Scholar
  • Sherpa Romeo
  • Open J Gate
  • Genamics JournalSeek
  • China National Knowledge Infrastructure (CNKI)
  • Electronic Journals Library
  • RefSeek
  • Hamdard University
  • OCLC- WorldCat
  • SWB online catalog
  • Virtual Library of Biology (vifabio)
  • Publons
  • Geneva Foundation for Medical Education and Research
  • Euro Pub
Share This Page