Treatment of cholangiocarcinoma (Klatskin tumor) with embolization or chemoembolization in University Hospital Halle (Saale)
University Hospital Halle (Saale)
Halle, Germany
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After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Chemoembolization <\/strong>begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.<\/p>\n\n<p style=\"text-align: justify;\">When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.<\/p>\n\n<p style=\"text-align: justify;\">Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.<\/p>\n\n<p style=\"text-align: justify;\">After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.<\/p>\n\n<p style=\"text-align: justify;\"><strong>After the first procedure<\/strong>, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan (not older than 3 months)<\/li>\n\t<li style=\"text-align: justify;\">Biopsy results (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the hospital<\/li>\n\t<li>Clinical history taking<\/li>\n\t<li>Review of available medical records<\/li>\n\t<li>Physical examination<\/li>\n\t<li>Laboratory tests:\n\t<ul>\n\t\t<li>Complete blood count<\/li>\n\t\t<li>General urine analysis<\/li>\n\t\t<li>Biochemical analysis of blood<\/li>\n\t\t<li>Tumor markers<\/li>\n\t\t<li>Inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>Coagulogram<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>Ultrasound\u200b scan<\/li>\n\t<li>CT scan \/ MRI<\/li>\n\t<li>Preoperative care<\/li>\n\t<li>Embolization or chemoembolization, 2 procedures<\/li>\n\t<li>Symptomatic treatment<\/li>\n\t<li>Cost of essential medicines<\/li>\n\t<li>Nursing services<\/li>\n\t<li>Elaboration of further recommendations<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align: justify;\"><strong>During the first visit<\/strong>, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Chemoembolization <\/strong>begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.<\/p>\n\n<p style=\"text-align: justify;\">When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.<\/p>\n\n<p style=\"text-align: justify;\">Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.<\/p>\n\n<p style=\"text-align: justify;\">After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.<\/p>\n\n<p style=\"text-align: justify;\"><strong>After the first procedure<\/strong>, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.<\/p>\n<\/div>","is_ambulant":"1","bh_fee":"0","only_for_children":"0","no_service":"0","with_prepayment":"1","show_calculator":"1","paket_type":"1","btn_type":"0","clinic_icon":"60004168eda58.jpg","city":"Halle","clinic_site":"http:\/\/www.medizin.uni-halle.de\/index.php?id=788","department_recommend":"1","country":"Germany","country_id":"1","clinic_name":"University Hospital Halle (Saale)","cinic_name":"University Hospital Halle (Saale)","department_id":"2042","duration":"7","direction":"Interventional radiology","min_duration":0,"clinic_id":"853","paketPrice":7800,"paket":"<ul>\n <li>Interpreter up to 17 hours<\/li>\n <li>Translation up to 10 pages<\/li>\n <li>Visa support<\/li>\n\n \n<\/ul>","title":"Treatment of cholangiocarcinoma (Klatskin tumor) with embolization or chemoembolization","price":{"val":27971.12,"type":"val"},"price_surcharge":0,"price_surcharge_clear":0,"extra_service_clinic":[],"extra_service":[],"translation_hours":"0","translation_doc_count":null,"roads":[{"id":"20","distance":"31","airport_title":"Leipzig"},{"id":"21","distance":"152","airport_title":"Dresden"},{"id":"8","distance":"169","airport_title":"Berlin"}],"pakets":[],"lang":{"day":"Day","days":"days","ambulatory":"Outpatient","stationaryProgram":"Inpatient"}}
Program id #
689672
Prof. Dr. Dr. med. Walter Wohlgemuth
Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
Specialized in: adult and pediatric diagnostic, interventional radiology, neuroradiology The program includes:
- Initial presentation in the hospital
- Clinical history taking
- Review of available medical records
- Physical examination
- Laboratory tests:
- Complete blood count
- General urine analysis
- Biochemical analysis of blood
- Tumor markers
- Inflammation indicators (CRP, ESR)
- Coagulogram
- Ultrasound scan
- CT scan / MRI
- Preoperative care
- Embolization or chemoembolization, 2 procedures
- Symptomatic treatment
- Cost of essential medicines
- Nursing services
- Elaboration of further recommendations
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.
Chemoembolization begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.
When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.
Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.
After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.
After the first procedure, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.
Required documents
- Medical records
- MRI/CT scan (not older than 3 months)
- Biopsy results (if available)
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About the department
The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology at the University Hospital Halle (Saale) offers the full range of modern radiological diagnostics and minimally invasive treatment both on an inpatient and outpatient basis. It has advanced equipment for conducting radiological studies in adults and children, as well as minimally invasive procedures under the guidance of imaging systems. There is maintained close cooperation with many departments of the hospital, which provides an interdisciplinary approach to treatment and comprehensive medical care. The department is headed by Prof. Dr. Dr. med. Walter Wohlgemuth.
One of the priorities of the department’s work is interventional radiology, which makes it possible to carry out various diagnostic and therapeutic manipulations using percutaneous accesses under the guidance of imaging devices. One of the clearest examples of this focus is digital subtraction angiography (CSA), which can image vessels with the best possible accuracy without overlapping images. Along with the imaging of blood vessels for diagnostic purposes, this method also allows for therapeutic interventions. For example, it can be used to restore (when treating thrombosis and arterial stenosis) or to block (in aneurysms or the risk of bleeding from tumor vessels) blood flow in the vessels. Both types of procedures – diagnostic imaging and interventions– can be applied to all parts of the body.
The department also has in its arsenal a digital two-level angiography, which allows to simultaneously perform two series of images using a single injection of a contrast agent, which reduces the radiation load on the patient and shortens the examination time. Also, two-level angiography offers a significantly higher safety with the introduction of a catheter for neuroradiological interventions (for example, removal of blood clots in acute stroke using a stent retriever and microcatheter).
The service range of the department includes:
Diagnostic radiology |
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Interventional radiology |
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Pediatric radiology |
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Neuroradiology |
|
Curriculum vitae
Education
Prof. Wohlgemuth studied medicine at the University of Regensburg, the Technical University of Munich and Ludwig Maximilian University of Munich, as well as Health Economics at the University of Bayreuth. In 1994 Admitted to medical practice, medical graduation from the Technical University of Munich in the same year. He worked as an Assistant Physician in the Department of Diagnostic Radiology and Neuroradiology, as well as in the Department of Neurology and Clinical Neurophysiology, Augsburg Hospital, and Department of Radiology, Ingolstadt Hospital.
Professional Career
- Since 2001, Chief Resident in Angiography, and since 2003 Senior Physician and Head of the Department of Vascular and Interventional Radiology.
- 2006 Accreditation as Neuroradiologist.
- Since 2002, Research Assistant at the Institute of Medical Management and Health Sciences at the University of Bayreuth.
- 2005 PhD defense at the Faculty of Economics, University of Bayreuth, Habilitation and Venia Legendi for "Medical Management and Health Sciences".
- From 2009 to 2011, Head of the Center for Vascular Malformations at the Augsburg Hospital.
- Since October 2011, University Professor and Head of the Department of Interventional Radiology at the University Hospital Regensburg.
- From 2012 to 2017, Head of the interdisciplinary Center for Vascular Anomalies at the University of Regensburg.
- From 2015 to 2017, Founder and Head of the first interdisciplinary Center for Pediatric Interventional Radiology in Germany.
- 2014 Research Fellowship at the Children’s Hospital in Boston, Harvard Medical School, and Children's Hospital in Philadelphia.
- Since June 2017, Head of the Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neroradiology at the University Hospital Halle (Saale) and Full Professor at the Martin Luther University of Halle-Wittenberg.
Memberships
- Since January 2017, President of the German Interdisciplinary Society for Vascular Anomalies.
Photo of the doctor: (c) Universitätsklinikum Halle (Saale)
About hospital
According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities!
The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a specialized medical facility for the treatment of very severe and rare diseases and injuries. It provides medical care for patients of all age groups in accordance with the very latest scientific achievements. It is worth noting that the hospital is characterized by its successful research activities, especially in the field of cardiovascular diseases and oncopathology. The specialists of these fields have made a significant contribution to the development of new diagnostic methods and therapeutic approaches.
The hospital diagnoses and treats more than 40,000 inpatients and about 120,000 outpatients every year. Such a large number of patients indicates the reliability and effectiveness of medical services.
Some structural units of the hospital deserve special attention. For example, the Central Department of Emergency Medical Care (the largest in Saxony-Anhalt), modern dental rooms, the Perinatal Center and the Transplant Center with a history of more than 40 years.
Thanks to the use of the cutting-edge medical technology and the availability of advanced equipment, many operations and procedures, which previously could entail a lot of risks and consequences, are currently performed in the hospital with the help of sparing techniques. In this context, it is worth noting hybrid heart interventions, robotic interventions in urology (da Vinci surgical system), etc.
In addition, the key to successful clinical practice is the availability in the hospital of experienced and competent medical staff. The total number of medical staff includes more than 4,000 medical employees. Many doctors are known far beyond the borders of Germany, they regularly carry out significant researches, which allow them to develop modern medicine. In addition, the hospital specializes in training of medical students, therefore the qualified doctors and professors are willing to pass on their experience to the younger generation.
Photo: (c) depositphotos
Accommodation in hospital
Patients rooms
The patients of the University Hospital Halle (Saale) live in comfortable single, double and triple patient rooms made in a modern design. All patient rooms are equipped with an ensuite bath with toilet and shower. The standard room includes a comfortable, automatically adjustable bed, a bedside table, a wardrobe, a table and chairs for receiving visitors and a TV. There is access to Wi-Fi. For security reasons, in some places, including in Intensive Care Units, it is forbidden to use laptops and mobile phones. In addition, the hospital offers enhanced-comfort patient rooms.
Meals and Menus
The patient and his accompanying person have a daily choice of three menus. If for any reason you do not eat all the food, you will be offered an individual menu. Please inform the medical staff about your dietary preferences prior to the treatment. Children are offered a special menu with healthy and tasty dishes, rich in nutrients necessary for the growing body.
Further details
Standard rooms include:
Toilet
Shower
Wi-Fi
TV
Religion
Religious services are available upon request.
Accompanying person
During the inpatient program, an accompanying person may stay with you in a patient room or hotel of your choice.
Hotel
During the outpatient program, you may stay in a hotel of your choice. Managers will help you choose the most suitable options.
