Related Experiment Video
Updated: Jun 5, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Are endoscopic or percutaneous biliary drainage effective for obstructive jaundice caused by hepatocellular
Hyun Chin Cho1, Jong Kyun Lee, Kwang Hyuck Lee
1Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Effective biliary drainage significantly improves survival in patients with obstructive jaundice caused by hepatocellular carcinoma (HCC). Key factors for successful drainage include lower bilirubin levels and better Child-Turcotte-Pugh class.
Area of Science:
- Hepatobiliary Surgery
- Gastroenterology
- Oncology
Background:
- Obstructive jaundice in hepatocellular carcinoma (HCC) patients typically has a poor prognosis.
- Biliary drainage is a critical intervention for managing obstructive jaundice.
Purpose of the Study:
- To evaluate the impact of effective biliary drainage on clinical outcomes in HCC patients with obstructive jaundice.
- To identify factors influencing effective biliary drainage and patient survival.
Main Methods:
- Retrospective analysis of 68 HCC patients with obstructive jaundice undergoing biliary drainage (endoscopic or percutaneous).
- Effective drainage defined as >30% total bilirubin decrease within 4 weeks.
- Risk factors for drainage success and mortality were analyzed.
Main Results:
- Effective biliary drainage achieved in 51.5% of patients.
- Independent predictors of ineffective drainage: total bilirubin >13 mg/dl, Child-Turcotte-Pugh C.
- Effective drainage correlated with improved Child-Turcotte-Pugh class and facilitated further HCC treatment.
- Mean survival: 247 days (effective drainage) vs. 44 days (ineffective drainage).
- Independent mortality predictors: age >63, ineffective drainage, no further HCC treatment.
Conclusions:
- Achieving effective biliary drainage in HCC patients with obstructive jaundice significantly improves survival.
- Early identification and management of factors predicting ineffective drainage are crucial.
Objectives:
The prognosis of patients with obstructive jaundice caused by hepatocellular carcinoma (HCC) has been reported to be poor. The aims of this study were to determine whether effective biliary drainage in patients with obstructive jaundice caused by HCC can affect clinical outcome and to identify those factors that affect effective biliary drainage and clinical outcome.
Methods:
The clinical records of 68 patients with obstructive jaundice caused by HCC who underwent endoscopic or percutaneous transhepatic biliary drainage from 1 January 2004 to 31 December 2008 were analyzed. Effective biliary drainage was defined as a decrease in total bilirubin level of more than 30% of the preprocedural value within 4 weeks.
Results:
(i) Effective biliary drainage was achieved in 51.5% of the patients who underwent a biliary drainage procedure. The independent risk factors for ineffective biliary drainage were total bilirubin more than 13 mg/dl and Child-Turcotte-Pugh class C. (ii) Patients with effective biliary drainage showed a significant improvement of Child-Turcotte-Pugh class and received additional treatment for HCC. (iii) The mean survival times of patients who received effective or ineffective biliary drainage were 247 and 44 days, respectively. (iv) The independent risk factors of mortality were an age of more than 63 years, ineffective biliary drainage, and no following treatment for HCC.
Conclusion:
When effective biliary drainage was achieved after an appropriate biliary drainage procedure in patients with obstructive jaundice caused by HCC, survival improved.
