Revision of Surgical Management of Malignant Obstructive Jaundice at Al-Bashir Teaching Hospital in Amman – Jordan

Faisal Ghraib, Raad

	Revision of Surgical Management of Malignant Obstructive Jaundice at Al-Bashir Teaching Hospital in Amman – Jordan
Kerbala Journal of Medicine
Article 1, Volume 6, Issue 1, 2013, Pages 1480-1488 PDF (0 K)
Author
Raad Faisal Ghraib
Abstract
background: Malignant Obstructive Jaundice (MOJ) is caused by different diseases at different levels and stages. Ideally, the best management is by early diagnosis and treatment with multi-disciplinary approach that includes the full cooperation among endoscopists, histopathologists, interventional radiologists, oncologists and surgeons. Objective: This analytic retrospective study puts a light on the management of MOJ patients the surgical department of Al-Bashir Teaching Hospital in Amman – Jordan. The gradual changes in the surgical management were taken in consideration. Method: The study included 98 patients who were treated surgically for MOJ during the period from June 1999 to June 2006. The age of these patients ranged from 27 years to 85 years, with the mean age being 62 years. The data obtained includes the investigations done, type, stage and level of MOJ, the type of surgical procedure and the postoperative complications within 1 month. Results: Most of the patients were males, 58 patients with a percentage of (59.18%). The remaining 40 patients were females with a percentage of (40.82%). The types of surgical management included Wipple's procedure for 16 patients with a percentage of (16.33%), tumor resection for 3 patients with a percentage of (3.06%), bypass (palliative) procedures for 69 patients with a percentage of (70.41%) and the remaining 10 patients with a percentage of 10.20%) were found to be inoperable during diagnostic laparotomy. In general, the surgical management had a morbidity of (18.37% - 18 patients) of which the mortality was (14.28% - 14 patients of these 18 morbid patients). Regarding investigation, U/S was performed for 62 patients only. It was positive in 30 patients with a percentage of (48.39%). Endoscopic Retrograde Cholangiopancreatography (ERCP) was done in 34 patients, it was positive in 18 patients with a percentage of (52.94%). Abdominal CT scan was performed for 44 patients, it was positive in 38 patients with a percentage of (86.36%). MRCP was done in 14 patients, it was positive in 12 patients with a percentage of (85.71%). Conclusion: MOJ is a disease occurring more frequently in middle age and elderly groups. Most of the patients are presented lately, making the most common surgical procedure performed for these patients being palliative (bypass) procedure. The use of sophisticated investigations is shown to aid in the diagnosis and staging of MOJ. Keywords: Malignant Obstructive Jaundice, Al-Bashir Teaching Hospital, Amman. Key Words: Hepatitis C virus, Hemodialysis, Al-kindy teaching hospital
Keywords
Malignant Obstructive Jaundice; Bashir Teaching Hospital; Amman

Statistics Article View: 89 PDF Download: 59