Shimada M, Takenaka K, Hasegawa H, Shirabe K, Gion T, Kano T, Sugimachi K
Second Department of Surgery, Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 1997 Sep-Oct;44(17):1432-7.
Icteric-type hepatocellular carcinoma, which initially presents as jaundice, is known to be rare. Furthermore, the number of such cases that undergo hepatic resection is also very small. The purpose of this study was to clarify the characteristics of icteric type hepatocellular carcinoma and discuss the efficacy of hepatic resection in this condition. Herein, we present five cases of icteric type hepatocellular carcinoma which were among a study of 438 patients who underwent hepatic resection. Most of these cases were in the advanced stages, and a high incidence of early death was recognized. However, two patients are doing well, without further recurrence (8 years and 7 months, and 13 months, respectively). It is important to consider icteric type hepatocellular carcinoma whenever a patient has a potential risk for hepatocellular carcinoma. In addition, it is also important to understand that in diagnosing icteric type HCC, sometimes neither choledocholithiasis nor cholangiocellular carcinoma can be clearly ruled out. Extensive examinations of the biliary tract, including percutaneous transhepatic cholangiography as well as endoscopic retrograde cholangiography are indicated for such patients when they exhibit either temporary cholangitis or jaundice, as well as when there is biliary dilatation within the liver. Furthermore, hepatic resection is also considered to be a viable alternative for such cases.
以黄疸为初始表现的黄疸型肝细胞癌较为罕见。此外，接受肝切除的此类病例数量也非常少。本研究的目的是阐明黄疸型肝细胞癌的特征，并探讨在此情况下肝切除的疗效。在此，我们报告了5例黄疸型肝细胞癌病例，这些病例来自对438例行肝切除患者的研究。这些病例大多处于晚期，且早期死亡率较高。然而，有2例患者情况良好，未出现进一步复发（分别为8年7个月和13个月）。当患者有肝细胞癌潜在风险时，考虑黄疸型肝细胞癌很重要。此外，还需明白，在诊断黄疸型肝癌时，有时无法明确排除胆管结石或胆管细胞癌。当此类患者出现暂时性胆管炎或黄疸，以及肝脏内有胆管扩张时，建议对其进行包括经皮肝穿刺胆管造影以及内镜逆行胆管造影在内的广泛胆道检查。此外，肝切除也被认为是此类病例的一种可行选择。
