Chotirosniramit Anon, Liwattanakun Akkaphod, Lapisatepun Worakitti, Ko-Iam Wasana, Sandhu Trichak, Junrungsee Sunhawit
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Hepatocell Carcinoma. 2017 Mar 7;4:41-47. doi: 10.2147/JHC.S126308. eCollection 2017.
Obstructive jaundice caused due to bile duct tumor thrombus (BDTT) in a hepatocellular carcinoma (HCC) patient is an uncommon event. This study reports our clinical experiences and evaluates the outcomes of HCC patients with BDTT in a single institution.
A retrospective review of 19 HCC patients with secondary obstructive jaundice caused due to BDTT during a 15-year period was conducted.
At the time of diagnosis, 14 (73.7%) patients had obstructive jaundice. Eighteen (94.7%) patients were preoperatively suspected of "obstruction of the bile duct". Sixteen patients (84.2%) underwent a hepatectomy with curative intent, while two patients underwent removal of BDTT combined with biliary decompression and another patient received only palliative care as his liver reserve and general condition could not tolerate the primary tumor resection. The overall early recurrence (within 1 year) after hepatectomy occurred in more than half (9/16, 56.3%) of our patients. The 1-year survival rate of patients was 75% (12/16). The longest disease-free survival time was >11 years.
Identification of HCC patients with obstructive jaundice is clinically important because proper treatment can offer an opportunity for a cure and favorable long-term survival.
肝细胞癌（HCC）患者因胆管肿瘤血栓（BDTT）导致的梗阻性黄疸是一种罕见事件。本研究报告了我们的临床经验，并评估了单一机构中患有BDTT的HCC患者的治疗结果。
对15年间19例因BDTT导致继发性梗阻性黄疸的HCC患者进行回顾性研究。
诊断时，14例（73.7%）患者出现梗阻性黄疸。18例（94.7%）患者术前被怀疑为“胆管梗阻”。16例（84.2%）患者接受了根治性肝切除术，2例患者接受了BDTT切除联合胆道减压术，另1例患者因肝脏储备和一般状况无法耐受原发性肿瘤切除而仅接受了姑息治疗。肝切除术后超过半数（9/16，56.3%）的患者出现早期复发（1年内）。患者的1年生存率为75%（12/16）。最长无病生存时间>11年。
识别患有梗阻性黄疸的HCC患者在临床上很重要，因为适当的治疗可以提供治愈机会和良好的长期生存。
