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 No | Endoscopy pre 1st PDT | Endoscopy | Symptoms | Treatment | Time after 1st PDT | Endoscopy | Symptoms | Treatment |
| n/a, data not available; CBD, common bile duct | ||||||||
| 1 | Normal | Normal | — | — | — | — | — | — |
| 2 | Normal | Duodenal necrosis (small area) | — | — | — | — | — | — |
| 3 | Normal | Duodenal necrosis | (A) Bleeding | Embolisation | — | — | — | — |
| (B) Obstruction | duodenal stent | |||||||
| 4 | Stenosed | (A) Duodenal stent before PDT | — | — | 2 months | Tumour ingrowth in stent | Obstruction | 2nd duodenal stent |
| (B) Duodenal stent in situ | — | — | — | — | — | — | ||
| 5 | Ulcerated ampulla | More extensive ulceration, duodenal stenosis | — | — | — | — | — | — |
| 6 | Normal | Duodenal necrosis | Bleeding | Endoscopic injection | — | — | — | — |
| 7 | Normal | Normal | — | — | — | — | — | — |
| 8 | Ulcerated ampullary tumour | n/a | — | — | (A) 10 months | Stenosis | Obstruction | Duodenal stent |
| (B) 26 months | Tumour ingrowth | Obstruction | 2nd duodenal stent | |||||
| 9 | Normal | Duodenal necrosis. CBD—duodenal fistula | — | Biliary stent | — | — | — | — |
| 10 | Ulcerated duodenum and ampulla | CBD—duodenal fistula | — | Biliary stent | 5 months | Stenosis | Obstruction | Duodenal stent |
| 11 | Ampullary tumour | Necrosis around stent | — | — | — | — | — | — |
| 12 | Normal | Duodenal necrosis (small area) | — | — | 16 months | Stenosis | — | — |
| 13 | Normal | Necrosis around ampulla. Stenosis | — | — | 3 months | Stenosis | — | — |
| 14 | Normal | (A) Duodenal necrosis | — | — | 13 months (3 months after last PDT) | Tumour in duodenal wall | Bleeding | Transfusion |
| (B) CBD—duodenal fistula | ||||||||
| (C) Further duodenal necrosis | ||||||||
| 15 | Normal | Normal | — | — | 14 months | Stenosis | Obstruction | Duodenal stent |
| 16 | Haemorrhagic, distorted duodenum | Ulcerated duodenum | Obstruction | Duodenal stent | 4 months | Stenosis | Obstruction | Gastroenterostomy |