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

Raad Faisal Ghraib*;

Karbala Journal of Medicine مجلة كربلاء الطبية
ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1480-1488
Publisher: Kerbala University جامعة كربلاء

Abstract

background: Malignant Obstructive Jaundice (MOJ) is caused by different diseases atdifferent levels and stages. Ideally, the best management is by early diagnosis andtreatment with multi-disciplinary approach that includes the full cooperation amongendoscopists, histopathologists, interventional radiologists, oncologists and surgeons.Objective: This analytic retrospective study puts a light on the management of MOJ patientsthe surgical department of Al-Bashir Teaching Hospital in Amman – Jordan. The gradualchanges in the surgical management were taken in consideration.Method: The study included 98 patients who were treated surgically for MOJ during theperiod from June 1999 to June 2006. The age of these patients ranged from 27 years to 85years, 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 postoperativecomplications within 1 month.Results: Most of the patients were males, 58 patients with a percentage of (59.18%). Theremaining 40 patients were females with a percentage of (40.82%). The types of surgicalmanagement 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 for69 patients with a percentage of (70.41%) and the remaining 10 patients with a percentage of10.20%) were found to be inoperable during diagnostic laparotomy. In general, the surgicalmanagement 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 62patients only. It was positive in 30 patients with a percentage of (48.39%). EndoscopicRetrograde Cholangiopancreatography (ERCP) was done in 34 patients, it was positive in 18patients with a percentage of (52.94%). Abdominal CT scan was performed for 44 patients, itwas positive in 38 patients with a percentage of (86.36%). MRCP was done in 14 patients, itwas 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 procedureperformed for these patients being palliative (bypass) procedure. The use of sophisticatedinvestigations 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 --- Al-Bashir Teaching Hospital --- Amman.