Surgical obstructive jaundice in India: a clinical profile
Kar, P.; Kumar, R.; Kapur, B.M.; Tandon, B.N.; Tandon, R.K.
Journal of the Association of Physicians of India 34(2): 115-118
1986
ISSN/ISBN: 0004-5772 PMID: 3710999 Document Number: 4657
A retrospective analysis of 130 patients with obstructive jaundice showed that 71.5% of them suffered from malignant lesions and 28.5% from benign lesions. Choledocholithiasis was the commonest benign lesion and carcinoma of the pancreas and gallbladder the commonest malignant lesions. They could be diagnosed correctly in 76% of patients with only clinical evaluation and in 93% with added biochemical tests. Cholangitis was the commonest manifestation of choledocholithiasis. Amongst the biochemical tests, alkaline phosphatase more than 30 KA units was the strongest pointer to the presence of 'surgical' obstructive jaundice and serum bilirubin more than 15 mg/dI to that of a malignant cause for the obstruction. Percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography were useful in defining all biliary obstructive lesions, but laparoscopy-aided biopsy was sufficient to establish the diagnosis in 16 patients with advanced carcinoma of the gallbladder which presented usually with a hard, nodular gallbladder lump in the right upper abdomen. Since most of these patients with advanced malignancies were unresectable, a cost-effective approach for investigating obstructive jaundice, utilising a bare minimum of the most specific investigative procedures should be developed.
Document emailed within 1 workday
