Management of Obstructive Jaundice Caused by Hepatocellular Carcinoma / 대한췌담도학회지

ABSTRACT

Jaundice is one of the poor prognostic factors in the patient with hepatocellular carcinoma (HCC). In HCC patients, the most common cause of jaundice is liver parenchymal dysfunction and jaundice due to biliary obstruction is relatively rare. However, it is clinically important because biliary obstruction can be treated effectively with biliary drainage procedure and by that quality of life and survival of the patient can be improved. It is important to identify the mechanism and location of the bile duct obstruction for an appropriate management of the biliary obstruction. Endoscopic retrograde biliary drainage (ERBD) has commonly been selected as the first-line treatment. However, percutaneous transhepatic biliary drainage or endoscopic ultrasound guided biliary drainage also can be used when the endoscopic approach is impossible or when ERBD fails. Between two types of stents - plastic or self-expandable metal, there is no definitive evidence about which one is superior. Stent type should be selected according to the characteristics of obstruction and expected survival of patient.