The efficacy of endoscopic palliation of obstructive jaundice in hepatocellular carcinoma.

Content Provider	Europe PMC
Author	Park, Semi Park, Jeong Youp Chung, Moon Jae Chung, Jae Bock Park, Seung Woo Han, Kwang-Hyub Song, Si Young Bang, Seungmin
Copyright Year	2014
Abstract	PurposeObstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention.Materials and MethodsFrom 1999 to 2009, 54 patients with HCC who underwent endoscopic intervention to relieve obstructive jaundice were included. We defined endoscopic intervention as a clinical success when the obstructive jaundice was relieved within 4 weeks.ResultsClinical success was achieved in 23 patients (42.6%). Patients in the clinical success group showed better Child-Pugh liver function (C-P grade A or B/C; 17/6 vs. 8/20), lower total bilirubin levels (8.1±5.3 mg/dL vs. 23.1±10.4 mg/dL) prior to the treatment, and no history of alcohol consumption. The only factor predictive of clinical success by multivariate analysis was low total bilirubin level at the time of endoscopic intervention, regardless of history of alcohol consumption [odds ratio 1.223 (95% confidence interval, 1.071-1.396), p=0.003]. The cut-off value of pre-endoscopic treatment total bilirubin level was 12.8 mg/dL for predicting the clinical prognosis. Median survival after endoscopic intervention in the clinical success group was notably longer than that in the clinical failure group (5.6 months vs. 1.5 months, p≤0.001).ConclusionBefore endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC.
ISSN	05135796
Volume Number	55
PubMed Central reference number	PMC4108811
Issue Number	5
PubMed reference number	25048484
Journal	Yonsei Medical Journal [Yonsei Med. J]
e-ISSN	19762437
DOI	10.3349/ymj.2014.55.5.1267
Language	English
Publisher	Yonsei University College of Medicine
Publisher Date	2014-09-01
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © Copyright: Yonsei University College of Medicine 2014
Subject Keyword	Hepatocellular carcinoma obstructive jaundice endoscopic retrograde cholangiopancreatography palliative treatment
Content Type	Text
Resource Type	Article
Subject	Medicine