• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.49-54
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• 1969

The present study has been undertaken to analyze scan manifestations in obstructive jaundice. Scan changes were cprrelated with the duration of jaundice. In addition, clearance rates of trace dose of colloidal radiogold were assessed in each case. The materials were consisted of 19 cases with surgically and/or histopathlogically verified obstructive jaundice from various causes including common duct stone, empyema of the gall bladder and carcinoma of the pancreas head etc. Blood clearance rates of colloidal $^{198}Au$ were determined after the injection of 8 uCi by simple geometrical drawing of recorded strip charts. Scan was performed following additional injection of the same radiogold. In 16 out of 19 cases, the scan revealed rather typical "arborifrom" mottlings around the porta hepatis. The intensity and appearance of such mottlings on the scan was related with the duration of jaundice and level of serum bilirubin and alkaline phosphatase. The blood clearance rates remained to be within normal range in 74 percent of the patients. In the remaining 26 percent, clearance rates ranged between 4.1 and 6 minutes. It is concluded that the association of "arboriform" mottlings and normal or mildly delayed clearance rates in the patients with jaundice is characteristic of obstructive changes in the biliary system.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.101-104
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• 2015

A 55-year-old man was admitted to the hospital for jaundice. Computed tomography (CT) scans showed a diffuse mass in the pancreas and peripancreatic area, with infiltration to of the whole pancreas, and overall reduced enhancement compared to normal pancreas. Esophagogastroduodenoscopy revealed elevated mucosal lesion covered hyperemic mucosa at duodenal bulb and ulcerative lesion at body of stomach. Endoscopic ultrasonography revealed an irregular mass with unclear boundaries was observed within the pancreas. Abrupt narrowing of mid to distal common bile duct was seen and the stricture was caused by compression of pancreatic mass. Plastic stent was inserted and clinical improvement was achieved including resolution of jaundice. The patient is currently being treated with combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone. We report a case of primary pancreatic lymphoma presenting with obstructive jaundice.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2543-2546
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• 2015

Purpose: Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice. Methods: Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test. Results: Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p< 0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p< 0.05). Conclusion: External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.204-209
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• 2010

Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9391-9394
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• 2014

Purpose: To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD) for patients with malignant obstructive jaundice. Methods: During the period of January 2008 and July 2013, internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During the procedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed. External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degree of bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect of IEPTBD. Results: Twenty newly onset of infection were recorded after procedure and new infectious rate was 47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 of them (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L before drainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp (P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P < 0.05). Conclusions: The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainage efficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients with malignant obstructive jaundice need to biliary drainage.

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.31-34
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• 2003

Purpose : To evaluate technical feasibility and clinical usefulness of CT fluoroscopy (CTF) guided PTBD immediately after CT scanning in ER Patients with obstructive jaundice. Materials and Method : ER patients diagnose4 as obstructive jaundice through cl

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2681-2684
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• 2014

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.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.165-170
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• 2008

The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7~9%. The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth. A 46-year-old woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days. Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filling defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.79-84
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• 1990

We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik Hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cGy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.

• The Korean Journal of Nuclear Medicine
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• v.5 no.2
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• pp.7-18
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• 1971

The liver function test was performed by means of two radioisotope tracer techniques in 20 normal subjects and in 63 patients with hepatobiliary diseases. The blood disappearance rates of $^{131}I$-rose bengal and of $^{198}Au$ colloid were determined by external counting method. The hepatocellular function and the hepatic blood flow were estimated from the observed data and the results were compared with those of the conventional liver function tests. The results obtained were as follows: 1. The mean blood disappearance half time of $^{131}I$-rose bengal was $6.6{\pm}0.63$ minutes in normal control, $17.7{\pm}6.93$ in cirrhosis of the liver, $16.6{\pm}4.80$ in acute hepatitis, and $14.7{\pm}3.46$ in obstructive jaundice. It was markedly prolonged in the hepatobiliary diseases as compared with the normal control, but there was no significant difference among the hepatobiliary diseases. 2. The mean blood disappearance half time of $^{198}Au$ colloid was $4.0{\pm}0.66$ minutes in normal control, $9.8{\pm}3.42$ in cirrhosis of the liver, $4.4{\pm}0.82$ in acute hepatitis, and $5.0{\pm}1.42$ in obstructive jaundice. The difference between cirrhosis of the liver and normal control Was statistically significant. However, there was no definite difference among acute hepatitis, obstructive jaundice, and normal control. The mean blood disappearance rate constant (K value) was $0.177{\pm}0.028/minute$ in normal control. In cirrhosis of the liver, it was markedly decreased which was suggestive of the reduced hepatic blood flow. 3. The ratio of $^{131}I$-rose bengal blood disappearance half time to $^{198}Au$ colloid disappearance half time was $1.68{\pm}0.20$ in normal control, $1.82{\pm}0.31$ in cirrhosis of the liver, $3.80{\pm}0.82$ in acute hepatitis, and $3.01{\pm}0.54$ in obstructive jaundice. The ratios in acute hepatitis and obstructive jaundice were remarkably higher than those in normal control and cirrhosis of the liver. 4. There was a significant correlation between the blood disappearance half time of $^{131}I$-rose bengal and that of $^{198}Au$ colloid in cirrhosis of the liver. 5. In cirrhosis of the liver, the blood disappearance half times of $^{131}I$-rose bengal and of $^{198}Au$ colloid were inversely correlated to the serum albumin level. In acute hepatitis, there was a good positive correlation between the blood disappearance half time of $^{131}I$-rose bengal and the serum transaminase activities. In obstructive jaundice, the blood disappearance half time of $^{131}I$-rose bengal was correlated to the serum bilirubin level.