In:
Digestion, S. Karger AG, Vol. 88, No. 2 ( 2013), p. 87-94
Abstract:
〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 To evaluate the clinical usefulness of endoscopic biliary drainage (EBD) in patients with hepatocellular carcinoma (HCC). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 111 jaundiced patients underwent attempted EBD for relief of HCC-related biliary stricture at our hospital over a 5-year period and all were included in the intention-to-treat (ITT) analysis. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 After an endoscopic attempt at drainage, 46 (41.4%) of the 111 patients achieved a favorable response. Biliary cannulation failed in 5 patients. Child-Pugh class C, portal vein thrombosis and severe hyperbilirubinemia were negatively correlated with a favorable EBD response. In the ITT population, 40 (87.0%) of the favorable responders received further treatment for HCC, 〉 2 (3.1%) of the unfavorable responders (p 〈 0.001). The median survival time for ITT patients with and without a favorable response to EBD was 8.7 and 1.3 months, respectively (p 〈 0.001). Cox's model showed that a favorable EBD response was an independent predictor of longer survival (hazard ratio 0.20, p 〈 0.001). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 For HCC patients with tumor-related biliary obstruction, predictors of effective endoscopic palliation of cholestasis were relatively mild hyperbilirubinemia and preserved liver function and intact portal vein flow. A favorable EBD response was associated with longer survival outcomes.
Type of Medium:
Online Resource
ISSN:
0012-2823
,
1421-9867
Language:
English
Publisher:
S. Karger AG
Publication Date:
2013
detail.hit.zdb_id:
1482218-0
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