No abstract available.
Jaundice, Obstructive*

BACKGROUND/AIMS: Biliary stenting is the most effective decompressive method for treating malignant biliary obstructive jaundice. Although the main cause of stent occlusion is tumor growth, few studies have investigated whether stent patency is affected by the combination of cancer-treatment modalities. The aim of this study was to evaluate the effects of local radiotherapy on metal-stent patency in patients with malignant biliary obstruction. METHODS: Patients who underwent self-expandable biliary metallic stenting for malignant biliary obstruction from 1999 to 2007 were included. Forty patients received chemotherapy and radiation therapy (radiation group, RG), and 31 patients received only chemotherapy (nonradiation group, NRG). RESULTS: The cumulative median stent patency was significantly longer in the RG than in the NRG (17.7 months; 95% confidence interval [CI], 1.8 to 33.6 months vs 8.7 months; 95% CI, 4.9 to 12.5 months; p=0.025). Stent occlusion caused by tumor growth or stent migration occurred in two (5%) and three (7.5%) cases in the RG and in six (19.3%) and two (6.5%) cases in the NRG, respectively. CONCLUSIONS: The patency of biliary metal stents in pancreatobiliary cancer patients who receive chemoradiation therapy is significantly longer than that in patients who do not receive radiotherapy, which suggests that local cancer control significantly affects stent patency.
Humans ; Jaundice, Obstructive ; Stents

No abstract available.
Drainage* ; Humans ; Jaundice, Obstructive*

No abstract available.
Jaundice, Obstructive* ; Pancytopenia* ; Ticlopidine*

We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cgy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.
Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Recurrence

As a adjuvant, 99m Tc-IDA complex cholescintigraphy has been used to differentiate the causes of jaundice,hepatocellular jaundice from the obstructive jaundice. So we conducted the retrospective study from the 41 casesof cholescintigraphy from the Mar, 83 to Sept. 84 at the Dept. of radiology in the Sonnchyunhyang university todetermine the etiology and differential points in the diagnosing the Jaundice. The following results wereobtainend; 1. As a 1st-ordered parameter, the leading edge hepatic parenchymal transit time was very significant in differentiating the causes of jaundice, among the hepatocellular jaundice, obstructive jaundice due to tumor,and obstructive jaundice due to cholelithiasis. (P<0.01 by X2-test) 2. As a 2nd-ordered parameter, hepaticclearance was very significant in differentiating the hepatocellular jaundice from the jaundice due to partialbiliary obstruction. (P>0.01 by t-test) 3. The difference in hepatic clearance between the biliary obstruction dueto tumor and that of the cholelithiasis, was not significant. (P>0.05 by X2-test) 4. The difference in bile ductdilatation among the hepatocellular jaundice obstructive jaundice due to tumor, and obstructive jaundice due tocholelithiasis, was singnificant in differentiating the causes of jaundice. (P<0.05 by X2-test) 5. Intrahepaticstone showed scintigraphic pooling with partial stasis. 6. Cholescintigraphy was useful to differentiated the Rotor's syndrome from the Dubin-Johnson syndrome, supplying the additional criteria.
Bile ; Cholelithiasis ; Jaundice ; Jaundice, Chronic Idiopathic ; Jaundice, Obstructive ; Retrospective Studies

Renal function in obstructive jaundice is one third of surgical cases of acute renal failure. Creatinin clearance in obstructive juandice deccrease> 50%. The nonoliguric acute renal failure may account for as much as 30 percent of all cases in obstructive jaudice without hypotension. After operation, patients with obstructive jaundice become nonoliguric acute renal failure accounted for 16 percent. Endotoxin is important pathogenic factor in reduction of renal function. Diagnosis of nononliguric renal failure when creatinin clearance reduces obviously. Pcr> 20mg/I or > 200 mol/I; RFI >3; FeNa>2.
Jaundice, Obstructive ; Bile Ducts ; Infection

Lymphoplasmacytic sclerosing pancreatitis, also referred to as autoimmune pancreatitis, is a benign disease characterized by irregular narrowing of the pancreatic duct, swelling of the pancreatic parenchyma, lymphoplasmacytic infiltration and fibrosis. A few cases with locally affected lesions show features similar to cancer. Lymphoplasmacytic sclerosing pancreatitis is the most common benign disease in patients undergoing Whipple resection for a presumed pancreatic malignancy. We report a case of lymphoplasmacytic sclerosing pancreatitis diagnosed after surgery in a patient presenting with obstructive jaundice, with a review of the literature.
Fibrosis ; Humans ; Jaundice ; Jaundice, Obstructive* ; Pancreatic Ducts ; Pancreatitis*

Percutaneous transhepatico-biliary duodenal drainage(PTBDD) (n=2) and percutaneous transhepatic duodenaldrainage(PTDD) (n=1) were performed as palliative treatment of obstructed afferent loop in patients in whomobstructive jaundice had occurred after surgery for malignant tumors. All three patients experienced septic shockafter PTBDD or PTDD. We describe these cases and review the literature.
Duodenum ; Humans ; Jaundice ; Jaundice, Obstructive* ; Palliative Care ; Sepsis ; Shock, Septic*

The most causes of an icteric hepatoma are a late stage hepatocellular carcinoma or intrahepatic cholangiocarcinoma. A hepatocellular carcinoma, causing an obstrucution of the bile duct, rarely results in jaundice. With a late stage hepatocellular carcinoma, the accurate diagnosis and treatment may be difficult. Herein, we report a case of a hepatocellular carcinoma and obstructive jaundice, due to hilar tumor emboli, with a review of the literature.
Bile Ducts ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Diagnosis ; Jaundice* ; Jaundice, Obstructive