Cholangiography in hepatocellular carcinoma with obstructive jaundice

Endoscopic retrograde cholangiography or percutaneous transhepatic cholangiography was performed in 22 patients suffering from hepatocellular carcinoma who presented with obstructive jaundice. Cholangiographic features included intraluminal filling defects within the major ducts causing complete or partial obstruction, involvement of the ductal system by tumour encasement resulting in a localised stricture or diffuse irregular strictures and dilatations, and displacement and stretching of the extrahepatic or intrahepatic ducts by tumour mass. Eight patients presented with more than one of these cholangiographic features. The observed cholangiographic features, though not specific for hepatocellular carcinoma, have provided an additional differential diagnosis in interpreting cholangiograms. The information obtained from cholangiography has also enabled selection of patients for surgery and allowed more accurate operative planning.