Journal article
ERCP and stent therapy for progressive jaundice in hepatocellular carcinoma : which patients benefit, which patients don't?
Digestive diseases and sciences, Vol.44(7), pp.1298-1302
1999
DOI: 10.1023/A:1026618927885
PMID: 10489909
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.
Details
- Title: Subtitle
- ERCP and stent therapy for progressive jaundice in hepatocellular carcinoma : which patients benefit, which patients don't?
- Creators
- John A Martin - University of Pittsburgh Medical CenterAdam Slivka - University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United StatesMordechai Rabinovitz - University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United StatesBrian I Carr - University of Pittsburgh Medical CenterJohn Wilson - University of Pittsburgh Medical CenterWilliam B Silverman - University of Pittsburgh Medical Center
- Resource Type
- Journal article
- Publication Details
- Digestive diseases and sciences, Vol.44(7), pp.1298-1302
- Publisher
- Springer
- DOI
- 10.1023/A:1026618927885
- PMID
- 10489909
- ISSN
- 0163-2116
- eISSN
- 1573-2568
- Language
- English
- Date published
- 1999
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984203348402771
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