Multidisciplinary approach to palliation of obstructive jaundice caused bya central hepatocellular carcinoma

Background/Aims: Obstructive jaundice due to intraductal tumour growth is a rare symptom in association with hepatocellular carcinoma (HCC), Methods: We report a 65-year-old white male who was admitted to our department with a 2-week history of progressive jaundice. Al laparotomy, the liver showed a dvanced cirrhosis due to longstanding biliary obstruction. Cholangiography confirmed total obstruction of the main bifurcation of the hepatic duct by intraductal tumour growth. Combination treatment with surgical segment III drainage, transcatheter arterial embolization and radioembolization with yt trium-90 resin particles and endoscopic stenting was performed. This form o f treatment has never been reported before. Results: With these combined pr ocedures, relief of jaundice and a survival time of 32 months could be achi eved. Conclusion: The combination of palliative methods may relieve jaundic e, ensure a good quality of life and possibly prolong survival in patients with mechanical tumour obstruction of the biliary tree by HCC. Copyright (C ) 1999 S. Karger AG, Basel.