In hepatocellular carcinoma, the obstructive jaundice due to tumor infiltration, hemobilia, or tumor compression is uncommon clinical feature. Only a few cases have been reported, since Mallory reported the first case in 1947.
The prognosis of hepatocellular carcinoma with bile duct tumor thrombosis has been reported very poorly. And most of the treatment used to be palliative procedure, such as T-tube com pression, ligation of hepatic artery, or transarterial embolization.
Recently, the development of surgical technique and perioperative metabolic management caused massive hepatic resection to do successfully.
From June 1984 to November 1993, 76 patients with hepatocellular carcinoma underwent operation at the Youngnam University Medical Center. Of them, 4 patients manifested with bile duct tumor thrombosis. We performed hepatectomy for 3 patients, and tumor embolectorny and T-tube decompression for 1 ´patient.
In conclusion the aggressive surgical resection of tumor considered to be proper management of hepatocellular carcinoma with bile duct tumor thrombosis for long term survival.
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