Korean J Gastrointest Endosc.  2005 Jun;30(6):305-311.

Efficacy of Percutaneous Cholangioscopic Ethanol Injection in Hepatocellular Carcinoma Invading the Bile Duct

• Choi JM
• Lee SK
• Lee SS
• Lee JH
• Song MH
• Pyun DK
• Song TJ
• Choi JS
• Park DH
• Seo DW
• Kim MH
• Min YI

Abstract

BACKGROUND/AIMS
To evaluate the clinical outcomes of the percutaneous cholangioscopic ethanol injection in the hepatocellular carcinoma (HCC) invading the bile duct, we conducted a retrospective study.
METHODS
Ten patients who received the percutaneous cholangioscopic ethanol injection were selected patients were diagnosed as HCC invading the bile duct between January 1998 and February 2004. Treatment response, complications, survival or death and survival time were analyzed.
RESULTS
Ten patients received mean of 5.3 sessions (range 2~19) of cholangioscopic ethanol injection. Eight patients had decreased tumor mass, and the rest 2 patients had no response. Complications were pain (n=10), hemobilia (n=6: bleeding was minimal), cholangitis (n=2), bile duct rupture (n=1), and bile duct stricture (n=1). Nine patients died from severe hepatic failure and sepsis, one patient has survived for 19 months as of now. Median survival time was 5 months (range 2~19 months). Percutaneous transhepatic biliary drainage (PTBD) could be removed in two patients.
CONCLUSIONS
Percutaneous cholangioscopic ethanol injection in HCC invading the bile duct showed size reduction of mass. PTBD could be no longer needed in some patients. However, supportive cares such as PTBD may be appropriate considering their short survival period and risk of procedure.

Keyword

Hepatocellular carcinoma; Bile duct invasion; Percutaneous cholangioscopic ethanol injection; Percutaneous transhepatic biliary drainage

MeSH Terms

Bile Ducts*
Bile*
Carcinoma, Hepatocellular*
Cholangitis
Constriction, Pathologic
Drainage
Ethanol*
Hemobilia
Hemorrhage
Humans
Liver Failure
Retrospective Studies
Rupture
Sepsis
Ethanol