Surgical Relief of Obstructive Jaundice in a District General Hospital

• Published in: Journal of the Royal Society of Medicine Vol. 78; no. 3; pp. 211 - 216
• Main Authors: Al-Fallouji, M A R, Collins, R E C
• Format: Journal Article
• Language: English
• Published: England SAGE Publications 01.03.1985
• Subjects: Adult; Age Factors; Aged; Bile - microbiology; Bilirubin - blood; Cholestasis - etiology; Cholestasis - surgery; Female; Gallstones - complications; Humans; Male; Middle Aged; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - mortality; Postoperative Complications; Retrospective Studies
• ISSN: 0141-0768; 1758-1095
• DOI: 10.1177/014107688507800308

Fifty consecutive patients with obstructive jaundice treated by operation in Canterbury & Thanet Health District hospitals under the care of one surgeon (RECC) over a 6-year period have been studied. The pathology was found to be common bile duct (CBD) stone in 22 patients (44%); pancreatic carcinoma in 15 (30%), 3 of whom also had CBD stones; chronic pancreatitis in 4 (8%); extrahepatic CBD carcinoma in 4 (8%); ampulla of Vater carcinoma in 3 (6%); primary duodenal carcinoma in 1 (2%); and portahepatis obstruction in 4 (8%). The 8 postoperative deaths (16%) were found to be associated with high preoperative levels of serum bilirubin, but all occurred in patients with malignant disease. Complications occurred in 20 patients (40%) and bile culture state was found to be intimately related to the morbidity rather than operative mortality. The study represents a careful audit of the pathology distribution and the surgical management of obstructive jaundice as seen in district hospitals.