Evaluation of cholangeographic procedures in diagnosis of obstructive jaundice
Satake, K.; Cho, K.; Tatsumi, S.; Kobayashi, K.; Umeyama, K.; Yamamoto, S.
American Surgeon 47(9): 387-392
1981
ISSN/ISBN: 0003-1348 PMID: 7283276 Document Number: 178097
Endoscopic retrograde cholangiography, percutaneous transhepatic cholangiography with external bile drainage and a combined method utilizing both procedures were evaluated in 187 patients with obstructive jaundice. Ductal obstructive regions were located in 90% of cases by endoscopic retrograde cholangiography and 55% of these were correctly diagnosed. Complications were observed in 7.9% with a mortality rate of 2.9%. The most serious complication was cholangitic sepsis. By percutaneous transhepatic cholangiography with external bile drainage, ductal obstructive regions were correctly located in 82%; 37% of these patients were correctly diagnosed. Complications occurred in 9.2% with a mortality rate of 1.5%. The most serious complication was massive bleeding. Successful external bile drainage could be obtained in most cases. The combined method overcomes the disadvantages of the single methods and the cause of obstructive jaundice can be diagnosed more precisely. The surgeon has a better knowledge of the type and the extent of the lesion prior to definitive surgery and can operate more safely on patients with obstructive jaundiced when the serum total bilirubin, has decreased to a level below 5 mg/dl.