Farhan Zaheer, Muhammad Iqbal Imrana Aziz, Qamar-uddin Baloch.
Postoperative Renal Impairment in Patients with Obstructive Jaundice.
J Surg Pak Jan ;19(3):104-7.

Objective: To determine the frequency of postoperative renal impairment in patients with obstructive jaundice. Study design: Descriptive case series. Place & Duration of study: Surgical Unit II Civil Hospital Dow University of Health Sciences Karachi, from March 2011 to April 2014. Methodology: Patients of obstructive jaundice, with age more than fifteen year , serum bilirubin levels above 3 mg/dL, admitted for surgical procedure were selected. Data containing details of age, etiology of jaundice, duration of jaundice, preoperative liver function tests, coagulation profile, procedure, pre and postoperative renal function, urine output, complications and mortality were collected. Creatinine clearance (C24) was done. If the patient had postoperative serum creatinine levels of >1.3 mg/ dL or urine output < 800 ml in 24 hours then C24 was also done. Renal impairment was labeled if C24 was < 40ml/min. All the data was analyzed on SPSS 17. Results: A total of 38 patients were included. Majority of the patients had history of jaundice for more than six week (mean=6.1±5.8 weeks). Ten (26%) patients developed renal impairment post-operatively out of which 4 (10%) had benign disease and 6 (15%) had malignant condition. No patient developed acute renal failure in immediate postoperative period. Conclusion: Postoperative renal impairment in obstructive jaundice patients occurred in quarter of the cohort studied despite adequate volume expansion.

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