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CardioVascular and Interventional Radiology

, Volume 25, Issue 3, pp 176–179 | Cite as

Obstructive Jaundice in Hepatocellular Carcinoma: Response after Percutaneous Transhepatic Biliary Drainage and Prognostic Factors

  • Joon Woo Lee
  • Joon Koo Han
  • Tae Kyoung Kim
  • Byung Ihn Choi
  • Seong Ho Park
  • Young Hwan Ko
  • Chang Jin Yoon
  • Kyung-Mo Yeon

Purpose: To evaluate the therapeutic effect of percutaneous transhepatic biliary drainage (PTBD) in patients with obstructive jaundice caused by biliary involvement of hepatocellular carcinomas (HCC) and to determine the prognostic factors. Methods: We retrospectively analyzed the data of 22 consecutive patients (M:F = 20:2, mean age 52.8 years). Inclusion criteria were the patient having obstructive jaundice caused by HCC that invaded the bile ducts and having at least 4 weeks of follow-up data after the PTBD. We defined "good response" and "poor response" as whether the level of total bilirubin decreased more than 50% in 4 weeks or not. Total bilirubin level (T-bil), Child-Pugh score and the location of biliary obstruction for the two groups were compared. In addition, the interval between clinical onset of jaundice and PTBD, the degree of parenchymal atrophy and the size of the primary tumor were compared. Results: Of the 22 patients, 13 (59.1%) showed good response. T-bil was significantly lower in the good response group than in the poor (14.2 ± 6 mg/dl vs 25.9 ± 13.8 mg/dl, p = .017). In the five patients with T-bil <10 mg/dl, four (80%) showed good response, while in nine patients with T-bil > 20 mg/dl, only three (33%) showed good response. Although statistically not significant, patients with Child score <10 showed better results [good response rate of 66.7% (12/18)] than patients with Child score ?10 [good response rate of 25% (1/4)]. Involvement of secondary confluence of the bile duct also served as a poor prognostic factor (p = 0.235). The interval between clinical onset of jaundice and PTBD, the presence of parenchymal atrophy and the size of the tumor did not show significant effect. Conclusion: Early and effective biliary drainage might be necessary in this group of patients with limited hepatic function.

Keywords

Prognostic Factor Bile Duct Hepatocellular Carcinoma Total Bilirubin Bilirubin Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag New York, Inc. 2002

Authors and Affiliations

  • Joon Woo Lee
    • 1
  • Joon Koo Han
    • 1
  • Tae Kyoung Kim
    • 1
  • Byung Ihn Choi
    • 1
  • Seong Ho Park
    • 1
  • Young Hwan Ko
    • 1
  • Chang Jin Yoon
    • 1
  • Kyung-Mo Yeon
    • 1
  1. 1.Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, KoreaKOREA

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