Korean J Gastrointest Endosc.  1996 Aug;16(4):681-691.

Hepatocellular Carcinoma with Obstructive Jaundice Confirmed by Percutaneous Transhepatic Cholangioscopy (PTCS) and Peroral Cholangioscopy (POCS)

• Kim YS
• Cho SW
• Hahm KB
• Kim JH
• Hong SJ
• Moon YS
• Lee KJ

Abstract

Jaundice associated with hepatocellular carcinoma usually occurs in the later stages due to the advanced underlying liver cirrhosis or tumor infiltration of the liver parenchyme. In the rare cases, obstructive jaundice presents as the ininitial manifestation of hepatocellular carcinoma. The possible mechanisms of bile duct obstruction associated with hepatocellular carcinoma include extrinsic compression of bile duct by extensive tumor infiltration of the liver or enlarged lymph node, direct tumor invasion of the biliary duct system, and bile duct obstruction by tumor thrombus, necrotic debris, or blood clots. We experienced three cases with hepatocellular carcinoma in whom obstructive jaundice were caused by intraductal involvement of the tumor, which were confirmed by percutaneous transhepatic cholangioscopy(PTCS) and peroral cholangioscopy(POCS). PTCS and POCS finding showed multiple, irreguarly shaped, yellowish soft tissue(chicken fat) and blood clots and, round protruded mass in the ble duct. Biopsy specimens revealed pathologically hepatocelluar carcinoma.

Keyword

Hepatocellular carcinoma; Obstructive jaundice; Percutaneous Transhepatic Cholangioscopy (PTCS); Peroral Cholangioscopy (POCS)

MeSH Terms

Bile Ducts
Biopsy
Carcinoma, Hepatocellular*
Cholestasis
Jaundice
Jaundice, Obstructive*
Liver
Liver Cirrhosis
Lymph Nodes
Thrombosis