Usefulness of preoperative biliary drainage: comparison of therapeutic strategies

• Published in: Annali dell'Ospedale Maria Vittoria di Torino Vol. 32; no. 7-12; p. 202
• Main Authors: Massaglia, F, Comotti, F, Aires, E, Coggiola, S, Fornari, M, Canino, V
• Format: Journal Article
• Language: Italian
• Published: Italy 01.07.1991
• Subjects: Aged; Bile; Cholestasis - surgery; Drainage; Emergencies; Endoscopy; Humans; Preoperative Care; Risk Factors
• ISSN: 0390-5454

This work shows the results obtained by the comparison between a period in which obstructive icterus was treated only surgically and a mixed period, based on endoscopic or endoscopic surgical treatment. In a period of 9 years (1979-87), 186 patients suffering from obstructive icterus were admitted into the 1st Division of General Surgery at Ospedale Maria Vittoria, Turin. In the first five years (1979-83) all the patients (78) were indistinctly operated after the usual diagnostic controls. In the following four years (1983-87) 62 out of 108 patients, considered as high-risk ones, underwent drainage by endoscopic way. In the high-risk patients, both neoplastic and not, morbidity rate, death rate and average stay in hospital were evidently lower after endoscopic or endoscopic-surgical treatment than after surgery alone. In conclusion, endoscopic pre-operating drainage in selected and/or high-risk patients greatly reduces perioperative complications and mortality.