Abstract
Jaundice in hepatocellular carcinoma (HCC) can be due to biliary obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) can be both diagnostic and therapeutic. Biliary stenting can relieve jaundice and allow further chemotherapy, but at additional expense and potential morbidity. We sought to determine whether CT scan or ultrasound (US) could identify which patients with HCC and jaundice would benefit from endoscopic stenting. We retrospectively analyzed 26 patients with HCC and jaundice who underwent ERCP after CT or US. We compared biliary dilation on CT or US with the dominant biliary stricture seen on ERCP, and with response to biliary stenting. Eleven of 26 patients had dominant biliary stricture on ERCP; 11 underwent stenting. Six of 11 (55%) stented patients had a significant decline in bilirubin; three became eligible for further chemotherapy. All six responders to stenting had biliary dilation on prior CT or US. Procedure- related complications occurred in 1/11 (9%) who underwent stent placement. In conclusion, in selected patients, stenting can safely relieve jaundice and allow subsequent chemotherapy. CT or US accurately predicted lesions that responded to stenting. ERCP and stenting provided no benefit in the absence of biliary dilation on CT or US.
| Original language | English |
|---|---|
| Pages (from-to) | 1298-1302 |
| Number of pages | 5 |
| Journal | Digestive Diseases and Sciences |
| Volume | 44 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 1999 |
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Keywords
- Biliary stricture
- Endoscopic retrograde cholangiopancreatography
- Hepatocellular carcinoma
- Stent
ASJC Scopus subject areas
- Gastroenterology
Cite this
ERCP and stent therapy for progressive jaundice in hepatocellular carcinoma : Which patients benefit, which patients don't? / Martin, John A.; Slivka, Adam; Rabinovitz, Mordechai; Carr, Brian I.; Wilson, John; Silverman, William B.
In: Digestive Diseases and Sciences, Vol. 44, No. 7, 1999, p. 1298-1302.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - ERCP and stent therapy for progressive jaundice in hepatocellular carcinoma
T2 - Which patients benefit, which patients don't?
AU - Martin, John A.
AU - Slivka, Adam
AU - Rabinovitz, Mordechai
AU - Carr, Brian I.
AU - Wilson, John
AU - Silverman, William B.
PY - 1999
Y1 - 1999
N2 - Jaundice in hepatocellular carcinoma (HCC) can be due to biliary obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) can be both diagnostic and therapeutic. Biliary stenting can relieve jaundice and allow further chemotherapy, but at additional expense and potential morbidity. We sought to determine whether CT scan or ultrasound (US) could identify which patients with HCC and jaundice would benefit from endoscopic stenting. We retrospectively analyzed 26 patients with HCC and jaundice who underwent ERCP after CT or US. We compared biliary dilation on CT or US with the dominant biliary stricture seen on ERCP, and with response to biliary stenting. Eleven of 26 patients had dominant biliary stricture on ERCP; 11 underwent stenting. Six of 11 (55%) stented patients had a significant decline in bilirubin; three became eligible for further chemotherapy. All six responders to stenting had biliary dilation on prior CT or US. Procedure- related complications occurred in 1/11 (9%) who underwent stent placement. In conclusion, in selected patients, stenting can safely relieve jaundice and allow subsequent chemotherapy. CT or US accurately predicted lesions that responded to stenting. ERCP and stenting provided no benefit in the absence of biliary dilation on CT or US.
AB - Jaundice in hepatocellular carcinoma (HCC) can be due to biliary obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) can be both diagnostic and therapeutic. Biliary stenting can relieve jaundice and allow further chemotherapy, but at additional expense and potential morbidity. We sought to determine whether CT scan or ultrasound (US) could identify which patients with HCC and jaundice would benefit from endoscopic stenting. We retrospectively analyzed 26 patients with HCC and jaundice who underwent ERCP after CT or US. We compared biliary dilation on CT or US with the dominant biliary stricture seen on ERCP, and with response to biliary stenting. Eleven of 26 patients had dominant biliary stricture on ERCP; 11 underwent stenting. Six of 11 (55%) stented patients had a significant decline in bilirubin; three became eligible for further chemotherapy. All six responders to stenting had biliary dilation on prior CT or US. Procedure- related complications occurred in 1/11 (9%) who underwent stent placement. In conclusion, in selected patients, stenting can safely relieve jaundice and allow subsequent chemotherapy. CT or US accurately predicted lesions that responded to stenting. ERCP and stenting provided no benefit in the absence of biliary dilation on CT or US.
KW - Biliary stricture
KW - Endoscopic retrograde cholangiopancreatography
KW - Hepatocellular carcinoma
KW - Stent
UR - http://www.scopus.com/inward/record.url?scp=0032783529&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032783529&partnerID=8YFLogxK
U2 - 10.1023/A:1026618927885
DO - 10.1023/A:1026618927885
M3 - Article
C2 - 10489909
AN - SCOPUS:0032783529
VL - 44
SP - 1298
EP - 1302
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
SN - 0163-2116
IS - 7
ER -