Experience with treatment of more than 800 patients with malignant stenosis of the biliary tract is reviewed. The significance of complex treatment using simple internal or external drainage, stent introduction, brachytherapy, percutaneous actinotherapy and locoregional chemotherapy is presented. Advantages of individual percutaneous methods are compared and indications for using metallic stent in patients with malignant stenosis of the biliary tract are evaluated. Significance and indications for the percutaneous treatment is discussed and its advantages are compared with the endoscopic approach.

• MeSH
• Cholangiocarcinoma complications   MeSH
• Cholestasis diagnostic imaging   etiology   therapy   MeSH
• Drainage * MeSH
• Radiography, Interventional MeSH
• Middle Aged MeSH
• Humans MeSH
• Bile Duct Neoplasms complications   MeSH
• Stents * MeSH
• Bile Ducts * MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

A case of long-standing subclinical cholesteryl ester storage disease (CESD) manifesting as hyperlipoproteinaemia type IIb without any hepatomegaly is described. The patient underwent surgical vascular interventions because of accelerated atherosclerosis, which dominated his middle age. CESD was an incidental finding when a liver biopsy specimen was taken because liver malignancy was suspected; the patient's condition proved to be due to a cholangiocarcinoma, which led to his death at the of age 52. The autopsy showed moderate-intensity storage in the set of cells characterized by constitutional high-level receptor-mediated LDL endocytosis (hepatocytes, adrenal cortical cells) and also revealed storage in the Leydig cells. The severity with which histiocytes were affected varied regionally, ranging from minimal detectable storage or none at all (gut, lymph nodes, spleen) to extreme lysosomal expansion by cholesteryl ester liquid crystals (bone marrow) or by ceroid (lung, testicular stroma), or by both (liver). The density of the histiocytic population did not correlate with the degree to which parenchymal cells were affected except in the testicular stroma, where it was prominent. The patient was a mixed heterozygote for the G934A and DeltaC(673-5) mutations.

• MeSH
• Arteriosclerosis complications   MeSH
• Cholangiocarcinoma complications   MeSH
• Chromatography, Thin Layer MeSH
• Adult MeSH
• Fatal Outcome MeSH
• Hyperlipoproteinemia Type II etiology   MeSH
• Leydig Cells metabolism   pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Lipase deficiency   genetics   MeSH
• Lysosomes enzymology   MeSH
• Bile Duct Neoplasms complications   MeSH
• Cholesterol Ester Storage Disease complications   metabolism   pathology   MeSH
• Testicular Diseases complications   metabolism   pathology   MeSH
• Bile Ducts, Intrahepatic * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Lipase MeSH