engleski

Clinical significance of obstructive jaundice

BACKGROUND: Obstructive jaundice results from a decrease in hepatic clearance caused by obstructive disorders of pancreaticobiliary tree. The most common cause of the biliary obstruction is choledocholithiasis. Approximately 10-15% of adults have gallstones, and choledocholithiasis is a common complication in 10-25% of these patients. Most algorithms recommend clinical and laboratory assessment first, then confirmation of obstruction by a non-invasive imaging methods such as transcutaneous abdominal ultrasound (US), computed tomography, or more recently magnetic resonance imaging or magnetic resonance cholangiopancreatography (MRCP) followed by endoscopic ultrasound (EUS) if the site of the obstruction is still unclear. Endoscopic retrograde cholangiography (ERCP) is used as a final diagnostic procedure providing therapy for the underlying disorder if appropriate. METHODS: Clinical data of 4587 patients admited to our departement from January 2002 to December 2003 were retrospectively reviewed. RESULTS: Obstructive jaundice was a cause for hospitalization of 687 patients (14, 97%, 246 males, 441 females, age 27-78, mean age 62 years). They have been hospitalized for a total of 5592 days, average 8.14 days/person. Etiology of obstruction was as follows: choledocholithiasis 286 (42%), pancreatic cancer 131 (19%), chronic pancreatitis 118 (17%), ampulary neoplasm 87 (13%), benign papillary stenosis 52 (7%), cholangiocarcinoma 13 (2%). A total of 852 US, 104 EUS, 179 MRCP and 839 ERCP procedures were performed. CONCLUSION: The evaluation of the patients with obstructive jaundice is a common clinical problem that requires skillful approach in management of various diagnostic and especially therapeutic procedures involved.

obstructive jaundice; choledocholithiasis; ultrasound; EUS; ERCP

nije evidentirano