Drainage Alone or Combined with Anti-tumor Therapy for Treatment of Obstructive Jaundice Caused by Recurrence and Metastasis after Primary Tumor Resection

  • Xu, Chuan ;
  • Huang, Xin-En ;
  • Wang, Shu-Xiang ;
  • Lv, Peng-Hua ;
  • Sun, Ling ;
  • Wang, Fu-An ;
  • Wang, Li-Fu
  • Published : 2014.03.30


Aim: To compare drainage alone or combined with anti-tumor therapy for treatment of obstructive jaundice caused by recurrence and metastasis after primary tumor resection. Materials and Methods: We collect 42 patients with obstructive jaundice caused by recurrence and metastasis after tumor resection from January 2008 - August 2012, for which percutaneous transhepatic catheter drainage (pTCD)/percutaneous transhepatic biliary stenting (pTBS) were performed. In 25 patients drainage was combined with anti-tumor treatment, antineoplastic therapy including intra/postprodure local treatment and postoperative systemic chemotherapy, the other 17 undergoing drainage only. We assessed the two kinds of treatment with regard to patient prognosis. Results: Both treatments demonstrated good effects in reducing bilirubin levels in the short term and promoting liver function. The time to reobstruction was 125 days in the combined group and 89 days in the drainage only group; the mean survival times were 185 and 128 days, the differences being significant. Conclusions: Interventional drainage in the treatment of the obstructive jaundice caused by recurrence and metastasis after tumor resection can decrease bilirubin level quickly in a short term and promote the liver function recovery. Combined treatment prolongs the survival time and period before reobstruction as compared to drainage only.


Metastatic tumor;surgical excision;jaundice;interventional treatment;antineoplastic therapy


  1. Westwood DA, Fernando C, Connor Sj, et al (2010). Internalexternal percutaneous transhepatic biliary drainage for malignant biliary obstruction: a retrospective analysis. J Med Imaging Radiat Oncol, 54, 108-10.
  2. Wang ZJ, Wang MQ, Duan F, et al (2013). Clinical application of transcatheter arterial chemoembolization combined with synchronous C-arm cone-beam CT guided radiofrequency ablation in treatment of large hepatocellular carcinoma. Asian Pac J Cancer Prev, 14, 1649-54.
  3. Wang N, Lv YZ, Xu AH, et al (2014). Application of lobaplatin in trans-catheter arterial chemoembolization for primary hepatic carcinoma. Asian Pac J Cancer Prev, 15, 647-50.
  4. Wang SY, Zhu WH, Vargulick S, et al (2014). Nausea and vomiting after transcatheter arterial chemoembolization for hepatocellular carcinoma: incidence and risk factor analysis. Asian Pac J Cancer Prev, 14, 5995-6000.
  5. Xiong ZP, Huang F, Lu MH (2012). Association between insulin-like growth factor-2 expression and prognosis after transcatheter arterial chemoembolization and octreotide in patients with hepatocellular carcinoma. Asian Pac J Cancer Prev, 13, 3191-4.
  6. Xu C, Lv PH, Huang XE, et al (2014). Safety and efficacy of sequential transcatheter arterial chemoembolization and portal vein embolization prior to major hepatectomy for patients with HCC. Asian Pac J Cancer Prev, 15, 703-6.
  7. Yu Li sol, Chang Won Kim, et al (2010). Early Infectious Complications of Percutaneous Metallic Stent Insertion for Malignant Biliary Obstruction. Vascular and Interventional. Radiology, 194, 261-5.
  8. Zhu HD, Guo JH, Teng GJ, et al (2012). A novel biliary loaded 125 I seeds in patients with malignant biliary obstruction: Preliminary results versus a conventional biliary stent. J Hepatol, 56, 1104-11.
  9. Ma TC, Shao HB, Xu Y, et al (2013). Three treatment methods via the hepatic artery for hepatocellular carcinoma - a retrospective study. Asian Pac J Cancer Prev, 14, 2491-4.
  10. Kong WD, Cao JM, Xu J, et al (2012). Impact of low versus conventional doses of chemotherapy during transcatheter arterial chemo-embolization on serum fibrosis indicators and survival of liver cancer patients. Asian Pac J Cancer Prev, 13, 4757-61.
  11. Li H, Hu Y, Li N, et al (2012). Liver fibrosis and five year survival of hepatocellular cancer cases undergoing transcatheter arterial chemo embolization using small doses. Asian Pac J Cancer Prev, 13, 1589-93.
  12. Lofts FJ, Evans TRJ J, Mansi L, et al (1997). Glees2 and M.J. K night. Bile Duct Stents: Is There an Increased Rate of Complications in Patients Receiving Chemotherapy? Eur J Cancer, 33, 209-13.
  13. Mao YM, Luo ZY, Li B, et al (2012). Prospective study on the survival of HCC patients treated with transcatheter arterial lipiodol chemoembolization. Asian Pac J Cancer Prev, 13, 1039-42.
  14. Pan H, Liang Z, Yin T, et al (2014). Hepato-biliary-enteric stent drainage as palliative treatment for proximal malignant obstructive jaundice. Med Oncol, 31, 853.
  15. Qian XJ, Zhai RY, Dai DK, et al (2006). Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment. World J gastroenterol, 12, 331-5.
  16. Simmons DT, Baron TH, Petersen BT, et al (2006). A novel endoscopic approach to brachytherapy in the management of Hilar cholangiocarcinoma. Am J Gastroenterol, 64, 1792-6.
  17. Todoroki T (2000). Chemotherapy for bile duct carcinoma in the light of adjuvant chemotherapy to surgery. Hepatogastroenterology, 47, 644-9.
  18. Cui L, Liu XX, Jiang Y, et al (2012). Comparative study on transcatheter arterial chemoembolization, portal vein embolization and high intensity focused ultrasound sequential therapy for patients. Asian Pac J Cancer Prev, 13, 6257-61.
  19. Ahn S, Lee Y, Lin K, et al (2013). Malignant biliary obstructions can we predict immediate postprocedural cholangitis after percutaneous biliary drainage? Support Care Cancer, 21, 2321-6.
  20. Burke DR, Lewis CA, Cardella JF, et al (2003). Quality improvement guidelines for percutaneous transhepatic cholagiography and biliary. J Vasc Interv Radiol, 14, 243-46.
  21. Choi JK, Kyu J, Lee S, et al (2013). Palliative Treatment of Unresectable Hepatocellular Carcinoma with Obstructive Jaundice Using Billiary Drainage with Subsequent Transarterial Chemoembolization. J Palliat Med, 16, 1026-33.
  22. Dambraukas Z, Paskauskas S, Lizdenis P, et al (2003). Percutaneous transhepatic biliary stenting: the first experience and results of the Hospital of Kaunas University of Medicine. Med (Kaunas), 44, 969-76.
  23. Ho CS, Warkentin AE (2013). Evidence-based decompression in malignant biliary obstruction. Korean J Radiol, 13, 56-61.
  24. Iruarrizaga E, Azkoma E, Martinez, et al (2011). Percutaneous transhepatic biliary drainage (pTBD) and endoscopic retrograde cholangiopancreatography (ERCP) for malignant obstructive jaundice (OJ) in advanced digestive cancers. J Clin Oncol, 29, 348.
  25. Jong EAde, Moelker A, Leertouwer T, et al (2013). Percutaneous transhepatic biliary drainage in patients with postsurgical bile leakage and nondilated intrahepatic bile ducts. Dig Surg, 30, 444-50.

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