Diagnostic and therapeutic ERCP on hepatocellular carcinoma with obstructive jaundice
- VernacularTitle:肝细胞癌所致梗阻性黄疸的ERCP诊断与治疗
- Author:
Bing HU
;
Daiyun ZHOU
;
Ping WU
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Jaundice;
Cholangiopancreatography, endoscopic ret-rograde
- From:
Chinese Journal of Digestive Endoscopy
1996;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discover the features of biliary obstruction in hepatocellular carcinoma (HCC) and evaluate the effectiveness of therapeutic ERCP in the management of such patients. Methods Two hundred and ninety two patients (male 234 and female 58) suffering from HCC with obstructive jaundice underwent 358 times of ERCPs between May 2000 and March 2003. The mean (SD) age and mean (SD) total serum bilirubin of these patients were 51. 9 ?10. 6 yrs and 232 ? 158?mol/L respectively. The profiles of cholangiographic changes were recorded. Two hundred and sixty cases received treatment under endosco-py. Then therapeutic techniques including sphinclerotomy and debris removal, naso-biliary drainage, plastic or metal stent placement or several procedures in combination were given to all patients except 32 cases in far advanced condition. The body temperature, amount of bile drained and changes in liver function test were observed within two weeks post-procedure and based on these data the therapeutic effectiveness was evaluated. Results According to the features of radiographic finding, five types of biliary obstruction were classified as: type Ⅰ - intrahepatic stricture or occlusion (5.9%); type Ⅱ - perihilar stricture or occlusion (19. 0% ) ; type Ⅲ - extrahepatic stricture or occlusion (18. 4% ) ; type Ⅳ - hilar intraductal tumor em-bolus (49. 4% ) ; and type Ⅴ - intraductal floating tumor debris (7. 3% ) . In 267 patients/times under follow-up, the symptomatic jaundice was improved in 82. 0% of the patients with significant reduction of serum bilirubin in 65. 5%. Conclusion ERCP plays an important role in both diagnosis and palliative management of the HCC patients with obstructive jaundice.
