Experience in treating patients with severe obstructive jaundice with benign cause

Abstract

We have analyzed treatment outcomes in 67 patients aged 26 to 84 years with severe obstructive jaundice with benign causes. Treatment began with the administration of intensive drug and infusion therapy during the first 2–3 days. When the latter was ineffective, at the first stage of treatment, minimally invasive methods of biliary decompression were used (percutaneous transhepatic cholangial drainage). After the normalization of liver function, at the second stage, traditional radical surgeries were performed (laparotomy, choledocholithoextraction with cholecystectomy and a blind suture of the choledochus, choledochoduodenostomy). If minimally invasive methods of biliary decompression cannot be used, surgical interventions (laparotomy or laparoscopy with choledochotomy and lithoextraction and external drainage of choledochus by Halsted-Pikovsky) were performed when manifestations of jaundice were maximal. Analysis of treatment outcomes in patients with severe obstructive jaundice showed that conservative intensive care was effective in 7.4 % of cases and led a resolution of severe obstructive jaundice without surgery, two-stage surgical approach was safer and more effective.