Clinical Profile and Management Techniques of Surgical Obstructive Jaundice Cases in a Tertiary Center at Bareilly
Received: 10. März 2019
Accepted: 16. April 2019
28. Juni 2019 (online)
Introduction Obstructive jaundice is associated with high morbidity and mortality. Obstructive jaundice is not a definitive diagnosis. Detailed evaluation to establish the etiology of the cholestasis and cause of obstruction is crucial to avoid secondary pathologic changes and to plan different surgical techniques to intervene at an early stage.
Materials and Methods A cross-sectional study was conducted among 50 cases of surgical obstructive jaundice at Shri Ram Murti Smarak Institute of Medical Sciences (SRMSIMS), Bareilly.
Results The mean age of this study population was 48.44 ± 8.2 years, and 48% (24) patients had obstructive jaundice of benign etiology, whereas 52% (26) had malignant etiology. Among males, the common presentation was choledocholithiasis in benign disease and carcinoma of the gallbladder among malignancy. In females also, disease presentation was similar to that of males. Percutaneous transhepatic biliary drainage (PTBD) was the most common method of biliary decompression in malignant group. For biliary decompression in patients of benign etiology, common bile duct (CBD) exploration with T-tube drainage was done in most cases.
Conclusion Obstructive jaundice has different etiologic spectrum in both males and females. Irrespective of etiology, common presentation was pain (94% of the cases). Most patients with malignant etiology presented with palpable lump. PTBD was the most common method of biliary decompression in malignant group. CBD exploration with T-tube drainage has higher values of decrease in serum bilirubin, serum bilirubin (indirect), serum alkaline phosphatase, and albumin.
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