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ID 61348
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Matsumi, Akihiro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Kato, Hironari Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences ORCID Kaken ID researchmap
Ueki, Toru Department of Internal Medicine, Fukuyama City Hospital
Ishida, Etsuji Department of Gastroenterology, Kurashiki Central Hospital
Takatani, Masahiro Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital
Fujii, Masakuni Department of Internal Medicine, Okayama Saiseikai General Hospital
Wato, Masaki Department of Gastroenterology, Kagawa Prefectural Central Hospital
Toyokawa, Tatsuya Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center
Harada, Ryo Department of Gastroenterology, Japanese Red Cross Okayama Hospital
Tsugeno, Hirofumi Department of Internal Medicine, Tsuyama Central Hospital
Matsubara, Minoru Department of Internal Medicine, Sumitomo Besshi Hospital
Matsushita, Hiroshi Department of Gastroenterology, Okayama City Hospital
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kaken ID publons researchmap
Abstract
Background
Only a few reports have assessed the effectiveness of endoscopic biliary drainage (EBD) in hepatocellular carcinoma (HCC) patients with obstructive jaundice and liver dysfunction.
Methods
This was a retrospective study based on the clinical databases from the Okayama University Hospital and 10 affiliated hospitals. All patients received EBD for jaundice or liver dysfunction. The indication for EBD was aggravation of jaundice or liver dysfunction with intrahepatic bile duct (IHBD) dilation. The technical and clinical success rate, complications, factors associated with clinical failure, and survival duration were evaluated.
Results
A total of 107 patients were enrolled in this study. Technical success was achieved in 105 of 107 patients (98.1%). Clinical success was achieved in 85 of 105 patients (81%). Complications related to endoscopic retrograde cholangiography (ERC) occurred in 3 (2.8%) patients. Child–Pugh class C (odds ratio 3.90, 95% confidence interval [CI] 1.47–10.4, p = 0.0046) was the only factor associated with clinical failure, irrespective of successful drainage. The median survival duration was significantly longer in patients with clinical success than in those without clinical success (5.0 months vs. 0.93 months; hazard ratio [HR] 3.2, 95% CI 1.87–5.37). HCC Stage I/II/III (HR 0.57, CI 0.34–0.95, p = 0.032), absence of portal thrombosis (HR 0.52, CI 0.32–0.85, p = 0.0099), and clinical success (HR 0.39, CI 0.21–0.70, p = 0.0018) were significant factors associated with a long survival.
Conclusions
EBD for obstructive jaundice and liver dysfunction in patients with HCC can be performed safely with a high technical success rate. Clinical success can improve the survival duration, even in patients expected to have a poor prognosis.
Keywords
Endoscopic retrograde cholangiopancreatography
Jaundice
Hepatocellular carcinoma
Liver dysfunction
Published Date
2021-01-13
Publication Title
BMC Gastroenterology
Volume
volume21
Issue
issue1
Publisher
BMC
Start Page
28
ISSN
1471-230X
NCID
AA12034934
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© The Author(s) 2021.
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isVersionOf https://doi.org/10.1186/s12876-020-01594-4
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http://creat iveco mmons .org/licen ses/by/4.0/