BPG is committed to discovery and dissemination of knowledge
Minireviews
Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Hepatol. Sep 27, 2026; 18(9): 124789
Published online Sep 27, 2026. doi: 10.4254/wjh.124789
Hepatocellular carcinoma with obstructive jaundice: Biliary drainage and multimodal therapy
Pan Xiao, Ke-Xin Chen, Lian-Lu Jiang, Li Zhang
Pan Xiao, Ke-Xin Chen, Li Zhang, Department of Interventional Medicine, Guilin People’s Hospital, Guilin 541000, Guangxi Zhuang Autonomous Region, China
Lian-Lu Jiang, Department of Hepatobiliary, Pancreatic and Splenic Surgery, First Affiliated Hospital of Hunan College of TCM (Hunan Province Directly Affiliated TCM Hospital), Zhuzhou 412000, Hunan Province, China
Co-first authors: Pan Xiao and Ke-Xin Chen.
Co-corresponding authors: Lian-Lu Jiang and Li Zhang.
Author contributions: Xiao P contributed to conceptualization, literature investigation, and writing - original draft; Chen KX contributed to literature search, evidence verification, and writing - review and editing; Xiao P and Chen KX contributed equally to this manuscript as co-first authors; Zhang L and Jiang LL contributed to conceptualization, supervision, project administration, and critical revision, and they contributed equally to this manuscript as co-corresponding authors. All authors read and approved the final manuscript.
AI contribution statement: OpenAI ChatGPT was used solely for English language editing and proofreading to improve grammar, clarity, and readability. The authors critically reviewed and approved all revisions. The AI tool was not used to generate scientific content, data, references, figures, tables, analyses, or conclusions. The authors take full responsibility for the accuracy, integrity, and originality of this manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Lian-Lu Jiang, Chief Physician, Researcher, Department of Hepatobiliary, Pancreatic and Splenic Surgery, First Affiliated Hospital of Hunan College of TCM (Hunan Province Directly Affiliated TCM Hospital), No. 50 Renmin Middle Road, Lusong District, Zhuzhou 412000, Hunan Province, China. jiexiu666@gmail.com
Received: June 24, 2026
Revised: July 23, 2026
Accepted: August 14, 2026
Published online: September 27, 2026
Processing time: 85 Days and 11.6 Hours
Core Tip

Core Tip: Patients with hepatocellular carcinoma-related jaundice should first be evaluated for a mechanical obstructive component rather than assumed to have irreversible liver failure. Endoscopic or percutaneous drainage may relieve cholestasis and allow treatment reassessment, but response definitions vary and apparent survival advantages are vulnerable to selection bias. Transarterial chemoembolization has the largest direct post-drainage evidence base; hepatic arterial infusion chemotherapy, radiotherapy, systemic therapy, and transplantation are supported mainly by small retrospective studies, case reports, or extrapolation. Drainage modality and subsequent treatment should be individualized by a multidisciplinary team, with clinical trials preferred whenever feasible.

Write to the Help Desk