Abstract
Purpose
To determine the necessity of preprocedural biliary drainage prior to chemoembolisation for hepatocellular carcinoma (HCC) with bile duct invasion.
Materials and Methods
The study included 52 patients who received chemoembolisation for unresectable HCC invading bile duct and causing hyperbilirubinemia (>3 mg/dL). Patients were divided into three groups according to biliary drainage and its effect: effective drainage (n=21), ineffective drainage (n=17), and non-drainage (n=14). Thirty-day mortality, length of hospitalisation, adverse events recorded using Common Terminology Criteria for Adverse Events (CTCAE), survival, and tumour response was compared among three groups.
Results
Thirty-day mortality rates were 14.3% (n=3), 17.6% (n=3), and 7.1% (n=1) for effective, ineffective, and non-drainage groups, respectively, and did not differ significantly among groups (p=0.780). The mean length of hospitalisation was shorter in non-drainage group compared to ineffective drainage group (12.1±11.4 vs 34.1±29.6 days, p=0.012). Mean differences in CTCAE grade for laboratory parameters before and after chemoembolisation were not significantly different among three groups. Survival among three groups was not significantly different (p=0.239–0.825). The tumour response was also not significantly different among three groups (p=0.679).
Conclusion
Biliary drainage may not be mandatory prior to chemoembolisation in patients with HCC invading the bile duct.
Key Points
• Chemoembolisation without biliary drainage can be performed for icteric HCC.
• Chemoembolisation without biliary drainage is not accompanied by increased adverse events.
• Preprocedural biliary drainage may not be mandatory for chemoembolisation for icteric HCC.
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The scientific guarantor of this publication is Hyo-Cheol Kim.
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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
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The authors state that this research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI16C1753).
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Methodology
• retrospective
• observational
• performed at one institution
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Park, J., Kim, HC., Lee, JH. et al. Chemoembolisation for hepatocellular carcinoma with bile duct invasion: is preprocedural biliary drainage mandatory? . Eur Radiol 28, 1540–1550 (2018). https://doi.org/10.1007/s00330-017-5110-7
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DOI: https://doi.org/10.1007/s00330-017-5110-7