Korean Journal of Gastrointestinal Endoscopy 2005;30(6): 305-311.
담도를 침범한 간세포암에서 경피담도경을 통한 알코올 주입술의 효과
최정민·이성구·이상수·이장한·송문희·변대근·송태준·최정식·박도현·서동완·김명환·민영일
울산대학교 의과대학 내과학교실
Efficacy of Percutaneous Cholangioscopic Ethanol Injection in Hepatocellular Carcinoma Invading the Bile Duct
Jung Min Choi, M.D., Sung Koo Lee, M.D., Sang Soo Lee, M.D., Jang Han Lee, M.D., Moon Hee Song, M.D., Dae Keun Pyun, M.D., Tae Jun Song, M.D., Jung Sik Choi, M.D., Do Hyun Park, M.D., Dong Wan Seo, M.D., Myung Hwan Kim, M.D. and Young Il Min, M.D.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
Background/Aims: To evaluate the clinical outcomes of the percutaneous cholangioscopic ethanol injection in the hepatocellular carcinoma (HCC) invading the bile duct, we conducted a retrospective study. Methods: Ten patients who received the percutaneous cholangioscopic ethanol injection were selected patients were diagnosed as HCC invading the bile duct between January 1998 and February 2004. Treatment response, complications, survival or death and survival time were analyzed. Results: Ten patients received mean of 5.3 sessions (range 2∼19) of cholangioscopic ethanol injection. Eight patients had decreased tumor mass, and the rest 2 patients had no response. Complications were pain (n=10), hemobilia (n=6: bleeding was minimal), cholangitis (n=2), bile duct rupture (n=1), and bile duct stricture (n=1). Nine patients died from severe hepatic failure and sepsis, one patient has survived for 19 months as of now. Median survival time was 5 months (range 2∼19 months). Percutaneous transhepatic biliary drainage (PTBD) could be removed in two patients. Conclusions: Percutaneous cholangioscopic ethanol injection in HCC invading the bile duct showed size reduction of mass. PTBD could be no longer needed in some patients. However, supportive cares such as PTBD may be appropriate considering their short survival period and risk of procedure. (Korean J Gastrointest Endosc 2005;30: 305311)
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