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The Efficacy of Endoscopic Palliation of Obstructive Jaundice in Hepatocellular Carcinoma

Authors
 Semi Park  ;  Jeong Youp Park  ;  Moon Jae Chung  ;  Jae Bock Chung  ;  Seung Woo Park  ;  Kwang-Hyub Han  ;  Si Young Song  ;  Seungmin Bang 
Citation
 Yonsei Medical Journal, Vol.55(5) : 1267-1272, 2014 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2014
Abstract
PURPOSE: Obstructive 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 METHODS: From 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. RESULTS: Clinical 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). CONCLUSION: Before 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.
Files in This Item:
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DOI
10.3349/ymj.2014.55.5.1267
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박세미(Park, Se Mi)
박승우(Park, Seung Woo) ORCID logo https://orcid.org/0000-0001-8230-964X
박정엽(Park, Jeong Youp) ORCID logo https://orcid.org/0000-0003-0110-8606
방승민(Bang, Seungmin) ORCID logo https://orcid.org/0000-0001-5209-8351
송시영(Song, Si Young) ORCID logo https://orcid.org/0000-0002-1417-4314
정문재(Chung, Moon Jae) ORCID logo https://orcid.org/0000-0002-5920-8549
정재복(Chung, Jae Bock)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99576
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