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KMID : 0371319720140120007
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Journal of the Korean Surgical Society
1972 Volume.14 No. 12 p.7 ~ p.12
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A Clinical Study of Postoperative Renal Failure in Obstructive Jaundice
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Abstract
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This report presents clinical studies of 202 cases of obstructive jaundice and 12 cases of postoperative renal failure, which were managed at surgical department of national medical center during a full 11 year period from Dec. 1959 to Dec. 1970. Surgical operations on deeply jaundiced patient are complicated by acute renal failure more often than comparable operations on non-jaundiced patient. Although the term "Hepatorenal Syndrome" does nothing to explain the reasons for the association between these conditions, it may be nevertheless be worth retaining as a reminder that this dangerous complication can develop. The results of this report are summarized as follows: 1 The incidence of postoperative acute renal failure in obstructive jaundice was 6.0%. 2. The ratio of male and female was 3 to 1. The average age was 43.7 years. 3. Obstructive jaundice caused by benign disease was 87.6% & by malignant tumor was 12.3%. and the incidence of postoperative renal failure was each 5.7% & 8.0% respectively. 4. The incidence of postoperative renal failure in malignant obstruction was 8.5%, however, that of cholangioma was most prominently high (28.6%). s. Postoperative renal failure was more frequently observed in cases of bypass surgery (30%) than that of radical surgery (5.4%) 6. The incidence of postoperative renal failure was proportional to preoperative level of serum bilirubin; 5 of 12 patients who developed this complication had a preoperative serum bilirubin level of more than 2Omg per 100 ml. All 5 patient died.7. Among 12 of postoperative renal failure, 3 patients, who had no cirrhotic changes of the liver. were survived while 7 of 9 expired patient had cirrhosis of the liver. 8. The operative mortality rate of obstructive jaundice was 8.9% and half of the operative death was due mainly to postoperative acute renal failure.
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