Management of obstructive jaundice: experience in a tertiary care surgical unit

ABSTRACT

To evaluate the presentation, clinical features and treatment of Obstructive Jaundice cases. Prospective observational study from Jan. 2003 to Dec. 2004. Surgical Unit IV, Civil Hospital, Karachi. All patients who were admitted and treated for Obstructive Jaundice. The patients were evaluated clinically and by investigations. After appropriate preparations surgery was carried out; the procedure depending upon the nature of the lesion. Intra and post-operative complications, and the outcome of the patient was noted and the whole data analyzed. This study comprises of 24 cases of Obstructive Jaundice. Their ages varied from 25-65 years [mean age being 41.12 years]; 10 were males and 12 females. Amongst these 13 [54.17%] patients had jaundice due to malignancy, 9 [37.5%] had stones in the common bile duct [CBD] and the remaining 2 [8.33%] patients had amoebic liver abscesses. In the malignant group five patients had Carcinoma Head of the Pancreas [two treated by pancreatoduodenectomy and three by cholecystojejunostomy], three had Cholangiocarcinoma [treated by hepatojejunostomy], three had Carcinoma Gall bladder [one treated by hepatojejunostomy, two inoperable] and two patients with malignant nodes at the porta hepatis who refused surgery and were referred for endoprostheses. All patients with stones in the CBD were treated by cholecystectomy and choledocholithotomy, whereas those with amoebic liver abscess underwent drainage/aspiration. Early diagnosis of the cause of obstruction is very important especially in malignant cases, as resection is only possible at that stage