title: Transcatheter arterial embolization for bleeding from bile duct tumor thrombi of hepatocellular carcinoma.
abstract: OBJECTIVE
  Advanced hepatocellular carcinoma usually invades the portal vein, forming tumor thrombi. Invasion of the bile duct, i.e., intrabile tumor growth or bile duct tumor thrombi is rare. Patients with bile duct tumor thrombi present with obstructive jaundice, abdominal pain or hemobilia. Hemobilia due to bile duct tumor thrombi is sometimes massive and fatal. The purpose of our study was to evaluate the effectiveness of transcatheter arterial embolization for hemobilia caused by bile duct tumor thrombi of hepatocellular carcinoma.
  
  
  METHODS
  Between 1993 January and 2000 December, transcatheter arterial embolization was performed in 4 patients with hemobilia and gastrointestinal bleeding from bile duct tumor thrombi of hepatocellular carcinoma.
  
  
  RESULTS
  In all 4 patients, transcatheter arterial embolization was successfully performed and resulted in cessation of bleeding. One patient had recurrent hemobilia, which was controlled by another transcatheter arterial embolization. Three patients were discharged from hospital after transcatheter arterial embolization. Patients died of hepatic failure or multiple tumors 5 to 7 months after the onset of hemobilia, although hemobilia had been fully controlled.
  
  
  CONCLUSIONS
  Transcatheter arterial embolization seemed to be effective for the control of massive hemobilia caused by bile duct tumor thrombi associated with hepatocellular carcinoma.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyoku, Kyoto, 606-8507, Japan. ksj@kuhp.kyoto-u.ac.jp
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shibata
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sagoh
authors.forename: Yoji
authors.initials: Y
authors.lastname: Maetani
authors.forename: Fumie
authors.initials: F
authors.lastname: Ametani
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubo
authors.forename: Kyo
authors.initials: K
authors.lastname: Itoh
authors.forename: Junji
authors.initials: J
authors.lastname: Konishi
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology*; D004621:Embolization, Therapeutic; D006431:Hemobilia / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D014057:Tomography, X-Ray Computed