Authors were made a retrospective clinical study on 211 cases of obstructive jaundice, who had been treated surgically for the duration of 5 years from Mar. 1987 to Mar. 1992 at the Dept. of General Surgery, Pusan National University Hospital and
the
results obtained were summarized as follows:
1) Of the 211 cases of obstructive jaundices, 171 cases(81.0%) were benign and 40 cases(19.0%) were malignant. Benign lesions include biliary stones 162 cases(94.7%), Clonorchis Sinensis 5 cases(2.9%), chledochal cyst 2 cases(1.2%),
pancreatitis,
sclerosing cholangitis each 1 cases(0.6%) respectively. Malignant lesions include cancer of bile duct 14 cases(35.0%), pancreatic head cancer 8 cases(20.0%), Ampulla of Vater cancer 7 cases(17.5%)
2) The sex ratio of male to female was 1 : 1.7 in benign cases and 1.2 :1 malignant. The age distribution were 6th decade, 16 cases(40.0%), 5th decade, 13 cases(32.5%0 in malignant cases.
3) The common symptoms were right upper quadrant pain, 168 cases(79.8%), epigastric discomfortness, 128 cases(60.8%), nausea and vomiting, 88 cases(41.6%), fever and chilling, 81 cases(38.2%). The common physical findings were right upper
quadrant
tenderness. 171 cases (80.9%), jaundice, 100 cases(47.2%), and hepatomegaly, 48 cases(22.5%).
4) The serum bilirubin level were under 5 mg% 95 cases(44.9%), 5.1~10mg% 31 cases(14.6%), over 15.1 mg% 23 cases(10.9%).
5) Ultrasonography was performed in 199 cases and positive rate was 85.4% and diagnostic postive rate was percutaneous transhepatic cholangiography 94.7%(36/38), endoscopic retrograde cholangiopancreatography 91.9%(34/37), and ultrasonography
85.4%(170/199) in the order.
6) The most frequently performed operative procedure were cholecystectomy with T-tube drainage 68 cases(39.8%), cholecystectomy with choledochoduodenostomy 32 cases(18.7%) and cholecystectomy with sphinctcteroplasty 29 cases(17.0%) in benign
cases
and
Whipple's operation 18 cases(45.0%) and Roux-en-Y choledochojejunostomy 6 cases(15.0%) in malignant cases.
7) The indidence of postoperative complications were 49 cases(32.2%) among 211 cases which were wound infection 13 cases(6.2%), pulmonary complication 10 cases(4.6%), bile leak 9 cases (4.1%), bowel adhesion 8 cases(3.8%), bleeding 8
cases(3.8%).
8) The mortality rates were 8 cases(2.5%), the causes of death were septicemia 3 cases(37.5%), hepatic failure 3 cases(37.5%), and renal failure 2 cases(25.0%).
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