Table 3

Duodenal effects of photodynamic therapy (PDT). Endoscopic findings are shown prior to PDT, in the first six weeks after PDT, and at longer follow up times, together with any intervention required for stenosis or haemorrhage

Early effects (up to 6 weeks)Late effects
Patient NoEndoscopy pre 1st PDTEndoscopySymptomsTreatmentTime after 1st PDTEndoscopySymptomsTreatment
n/a, data not available; CBD, common bile duct
2NormalDuodenal necrosis (small area)
3NormalDuodenal necrosis(A) BleedingEmbolisation
(B) Obstructionduodenal stent
4Stenosed(A) Duodenal stent before PDT2 monthsTumour ingrowth in stentObstruction2nd duodenal stent
(B) Duodenal stent in situ
5Ulcerated ampullaMore extensive ulceration, duodenal stenosis
6NormalDuodenal necrosisBleedingEndoscopic injection
8Ulcerated ampullary tumourn/a(A) 10 monthsStenosisObstructionDuodenal stent
(B) 26 monthsTumour ingrowthObstruction2nd duodenal stent
9NormalDuodenal necrosis. CBD—duodenal fistulaBiliary stent
10Ulcerated duodenum and ampullaCBD—duodenal fistulaBiliary stent5 monthsStenosisObstructionDuodenal stent
11Ampullary tumourNecrosis around stent
12NormalDuodenal necrosis (small area)16 monthsStenosis
13NormalNecrosis around ampulla. Stenosis3 monthsStenosis
14Normal(A) Duodenal necrosis13 months (3 months after last PDT)Tumour in duodenal wallBleedingTransfusion
(B) CBD—duodenal fistula
(C) Further duodenal necrosis
15NormalNormal14 monthsStenosisObstructionDuodenal stent
16Haemorrhagic, distorted duodenumUlcerated duodenumObstructionDuodenal stent4 monthsStenosisObstructionGastroenterostomy