Obstructive jaundice in gastric carcinoma: cause, site, and relationship to the primary lesion

Abstract

Our results show that the cause of bile duct obstruction in advanced gastric carcinoma is predominantly metastatic lymphadenopathy in the hepatoduodenal ligament, and its preferential site is around the level of the cystic duct. Obstructing lesions showed characteristic cholangiographic findings.

Poorly Differentiated Gastric Adenocarcinoma Can Mimic Hilar Cholangiocarcinoma

“…The cause of obstructive jaundice in patients with primary gastric cancer has been widely ascribed to metastatic lymphadenopathy in the hepatoduodenal ligament (HDL) (2). A large metastatic mass in the liver can also cause hilar biliary obstruction at the confluence of the RHD and the LHD due to extrinsic compression (8).…”

“…The progression of gastric cancer induces various signs and symptoms including obstructive jaundice, which is a debilitating complication that can result in recurrent sepsis. The most commonly observed site of biliary obstruction is in the vicinity of the cystic duct (2). Several causes of extrahepatic biliary duct obstruction have been found, including gallbladder stones, tumor thrombosis, metastasis to hepatoduodenal (#12a, 12b, 12p) or pancreaticoduodenal lymph nodes (LNs) (3), and direct neoplastic invasion from the primary tumor or recurrent malignancies in the stomach.…”

Obstructive jaundice caused by lymphangitis carcinomatosa of bile duct wall from gastric carcinoma

“…The lymphatic vessels and lymph nodes in the gastrohepatic ligament are frequent site of metastases from carcinoma of the stomach [1][2][3][4]. Obstructive jaundice is a serious complication of advanced gastric carcinoma.…”

“…Obstructive jaundice is a serious complication of advanced gastric carcinoma. Lee et al [1] retrospectively analyzed cholangiographic findings in 54 patients with advanced gastric carcinoma presenting with obstructive jaundice. The causes of bile duct obstruction were lymph node metastases (93%) in the hepatoduodenal ligament and direct invasion of the primary gastric tumor or recurrent tumor (7%).…”

“…Usually, the causes of bile duct obstruction are predominantly metastatic lymphadenopathy in the hepatoduodenal ligament and/or direct invasion by gastric tumor [1]. We report a case of advanced gastric carcinoma that presented with obstructive jaundice because of lymphangitis carcinomatosa within the extrahepatic bile duct wall.…”