The prevention and managemant of early post-cholecystectomy jaundice / 中国普通外科杂志

ABSTRACT

Objective To study the prevention and management of early post-cholecystectomy jaundice.Methods The dinical data of 43 cases of jaundice occurring within one week after simple open cholecystectomy in 11 226 cases were retrospectively analyzed.Results The incidence of jaundice at one week after operation was 0.38% in simple open cholecystectomy,among them,medical jaundice accounted for 18 cases,and surgical jaundice for 25cases.Ultrasound,ERCP,MRCP,liver enzyme profile and reoperation confirmed the folowing: Extra-hepatic bile duct or the right hepatic duct was ligated in 9 cases,common bile duct residual stone in 6,partial gallbladder or gallbladder duct stone in 4,biliary leak in 4,cholangitic hepatitis in 4,hepatitis B or posthepatitis cirrhosis in 5,icterus after blood transfusion in 2,hemobilia in 2,ligation of right branch of hepatic artery in 2,and icterus of unknown causes in 5 cases.Reoperation was done in 8 cases,with one mortality.Conclusions Detailed case history,adequate examination before operation,and careful operative technique are the essential prerequisites to prevent early post-cholecystectomy jaundice.Early post-cholecystectomy jaundice should be treated according to the different causes.