폐쇄성 황달을 동반한 간세포암 환자에서 담관조영소견의 분석 = Cholangiographic Findings in Hepatocellular Carcinoma Patients with Obstructive Jaundice폐쇄성 황달을 동반한 간세포암 환자에서 담관조영소견의 분석

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Background/Aims: Jaundice is present in 19-44% of patients with hepatocellular carcinoma(HCC) at the time of diagnosis. The mechanisms of jaundice are associated with cirrhosis, tumor infiltration into the hepatic parenchyma, and bile duct obstruction. Causes of obstructive jaundice secondary to bile duct obstruction in HCC are bile duct invasion of tumor, tumor thrombi, blood clot of hemobilia, and direct bile duct compression of tumor or metastatic lymph n3e. Methods: To evaluate levels and causes of bile duct obstruction in HCC patients with obstructive jaundice and to assess its survival according to causes of obstructive jaundice, we performed retrospective study, from March 1992 to June 1994, with HCC patients with obstnictive jaundice who under- went endoscopic retrograde cholangogiraphy and/or percutaneous transhepatic cholangiography. Results: The commonest level of bile duct obstruction was common hepatic duct(35.3%), followed by common bile duct(23.5%). The causes of obstruction type were tumor invasion(58.8%), tumor thromhi(29.4%), blood clot with hemobilia(5.97o), and bile duct compression hy tumor (5.9%), in order. The level of bile duct obstruction in most cases of tumor invasion was common hepatic duct while in cases of tumor thrombi, common bile duct was the frequent site. There v:as no difference in levels and types of bile duct obstruction according to tumor types of HCC. The su.rvival period of patients with tumor thrombi was significantly longer than that of patients with bile duct invasion(p0.05). Conclusions; HCC involving bile duct will be found frequently with increased use of direct cholangiograpy. The commonest type of bile duct obstruction in HC'C was duct invasion, so aggressive and adequate treatment for HCC may be useful in management of bile duct obstruction. (Korean J Gastroenterol 1996;28: 101 - 110)