Bile duct obstruction in hepatocellular carcinoma (hepatoma)--clinical and cholangiographic characteristics. Report of 6 cases and review of the literature.

Direct cholangiography revealed 6 cases of hepatoma where tumor growth within the bile ducts caused obstructive jaundice. Characteristic features included bulky obstructing intraluminal masses in the proximal extrahepatic ducts. Distal common duct defects usually signify hemobilia and clots as tumor complication. Review of the literature disclosed only 22 cases in which common duct involvement was a predominant clinical feature. Hepatoma should be included in the different diagnosis of a cholangiographic filling defect in the proximal extrahepatic bile ducts. The recent widespread use of endoscopic and fine needle transhepatic cholangiography should aid in preoperative diagnosis.