Suramya Anand1, Charan Panda2, Aakala Trishul Senapati3, Manas Ranjan Behera4, Chittaranjan Thatei5
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.
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.
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.
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.