A Study on Incidence, Clinical Profile, and Management of Obstructive Jaundice

Abstract

BACKGROUND Jaundice is a frequent manifestation of biliary tract disorders and the evaluation and management of obstructive jaundice is a common problem faced by the general surgeon. During the last decade significant advances have been made in our understanding with regards to the pathogenesis, diagnosis, staging, and efficacy of surgical and nonsurgical management of obstructive jaundice. To diagnose the cause, site of obstruction, and management of a case of surgical jaundice is indeed a challenging task for the surgeon. Hence, a comprehensive study of the aetiology, clinical presentation, and management of obstructive jaundice is of paramount importance in the appropriate management of these patients. AIM This study evaluates the age and sex distribution, clinical presentation, aetiology, and the different modalities of treatment of obstructive jaundice. MATERIALS AND METHODS This prospective study was conducted in MKCG Medical College and Hospital, Berhampur, Odisha from September 2013-August 2015. Out of all surgical admissions from September 2013 to August 2015 in our hospital, 80 cases of surgical jaundice of different age group were selected randomly. A detailed history and clinical examination was done and appropriate investigations recorded. Patients were assessed preoperatively and later subjected to surgery or palliative procedure depending on the need. Postoperatively, patients' condition was assessed and complications were documented. Patients were followed up for mean period of 6 months where patients underwent surgical intervention/ERCP, any tissue removed was subjected for histopathological examination. RESULTS The occurrence of surgical jaundice was maximum in the 31-70 year age group. All patients presented with icterus and ultrasonogram was the most common investigation of choice. Most common cause of obstruction was choledocholithiasis followed by malignancy. CONCLUSION Commonest symptom of surgical jaundice in this study was pain abdomen and jaundice as per history. Commonest cause for surgical jaundice was found to be choledocholithiasis. Open exploration of common bile duct under experienced hands was found to be a good treatment modality in the management of obstructive jaundice.

A clinical Study of Obstructive Jaundice Due to Biliary Calculi And Its Management

“…Various authors reported incidence of different clinical features of obstructive jaundice due to biliary calculi consistent with the current study are given in Table 5. The high level of (mean) Gamma Glutamyl Transferase (GGT), i.e., 233 of the present study agree Peng WK et al, 18 and Anciaux ML et al 19 Also, the mean serum albumin level of 3.94 gm% of the present study is in support of Anand S et al, 11 and Kumar PN et al 15 In our study, USG of abdomen detected biliary calculi in 90 out of 100 patients screened and thus showed a sensitivity of 90%. Stones were also found during interventions in these 90 patients.…”

Clinical profile of patients with obstructive jaundice: a surgeon’s perspectives

“…18 Other studies also have reported similar age groups to be involved in obstructive jaundice. [15][16][17] Obstructive jaundice is one of the 118, 58.71% 83, 41.29%…”

“…In a study done by Anand et al regarding clinical profile and the different modalities of treatment of obstructive jaundice, it was reported that common cause of obstructive jaundice was choledocholithiasis followed by malignancy. 15 In an Ethiopian study, it was reported that choledocholithiasis as the most common benign cause of obstructive jaundice. 24 According to literature, choledocholithiasis, primary or secondary, is the commonest cause of obstructive jaundice.…”

“…11 An accurate diagnosis can usually be made with combination of different approaches like, history, physical examination, and biochemical tests, and when appropriate cholangiography and liver biopsy and observation of the patient's course. 12 Early and precise detection of etiology of obstructive jaundice can help surgeons to accurately manage such patients and thus will improve quality of life of patient and improving the survival rates among the patients with malignant pathology. 13 Hence, present study was undertaken study the clinical profile of patients with obstructive jaundice..…”

An Observational Study for Causes of Surgical Jaundice at Tertiary Care Hospital

“…Obstructive jaundice has been commonly defined as a type of disease that is taking place because of the block in the pathway around the site of conjugation of the bile among the liver cells besides the entry of bile inside the duodenum with the help of ampulla.The block might also be either type of intrahepatic or extra hepatic across the bile duct. [1] There is a need of comprehensive study based on the gender and age distribution of the patients along with their clinical presentation and the etiology of the obstructive jaundice is indeed of some paramount importance while carrying out the appropriate management of the patients having surgical jaundice. [2] Both invasive and non-invasive diagnostic investigation are available in order to diagnose and carry out the proper diagnosis of the surgical jaundice.But several invasive investigations might be leading to cholangitis.…”