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The clinical outcomes of endoscopic biliary drainage for malignant biliary obstruction due to hepatocellular carcinoma
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Haruo Miwa1,
Kazushi Numata1,
Shin Maeda2 |
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1Yokohama City University Medical Center, Gastroenterological Center, 2Yokohama City University Graduate School of Medicine, Department of Gastroenterology |
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| Aim: To evaluate the clinical outcomes of endoscopic biliary drainage for malignant biliary obstruction (MBO) due to hepatocellular carcinoma (HCC). Methods: Twenty-seven patients with MBO due to HCC who underwent endoscopic biliary drainage between April 2013 and October 2023 were included. The patient's background, procedural details, and prognosis were retrospectively analyzed. Result: The study involved 10 women with a median age of 70 years (56-83 years). The median T.Bil level before biliary drainage was 5.4 mg/dL. Eleven (41%) patients were classified as Bismuth 3 or 4. Regarding biliary drainage, 9 (33%) patients initially underwent nasobiliary drainage, and 6 (22%) patients required multiple stents. The technical success rate was 100 % and the clinical success rate was 70% (19/27). No adverse events occurred. T.Bil level of less than 5mg/dL before biliary drainage was the factor significantly correlated with clinical success. The median overall survival (OS) was 3.4 months, and the 1 year OS rate was 11%. RBO occurred in 14/19 (74%) patients and the median time to RBO was 2.9 months. In a case treated with Durvalumab and Tremelimumab after biliary drainage, the stent was removed 4 months later due to the improvement of the stricture. Conclusion: The patients with MBO due to HCC had extremely poor prognoses; however, early drainage can lead to clinical success. |
Index Term 1: HCC
Index Term 2: Biliary drainage
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