Therapy is always palliative.
In the past 20 years treatment results have not improved. Patients treated should be entered in controlled clinical studies with new substances randomized versus less toxic 5-FU or optimum supportive care. Pain and jaundice can be relieved by radiotherapy, bypass surgery and stent insertion. The choice of an option should be made according to patient characteristics and risk factors, as well as the possibilities and experience of the treating center. ILBT was performed with transhepatic percutaneous drainage in four patients and with endoscopic retrograde cholangiopancreatography in 27.