Muhammad Naeem Afzal, Qamar Ashfaq Ahmad, Shabbar Hussain Changazi, Samiullah Bhatti, Usman Ali Rahman, Muhammad Zain-ul Abdin.
Diagnostic Outcomes and Management of patients Presenting with Obstructive Jaundice in Surgical Department of services Hospital Lahore: a Prospective Cross Sectional Study.
Pak J Med Health Sci Jan ;13(1):181-4.

Background: Bile, the major constituent of digestive juice is produced by liver and flows through bile ducts into duodenum. Increase serum bilirubin due to bile outflow obstruction results in obstructive jaundice. Major causes of obstructive jaundice are choledocholithiasis, pancreatic ca cholangiocarcinoma, periampullary ca Aim: To discover the causative parameters of obstructive/surgical jaundice and the results of management in a local context (setting). Methods: This was a cross sectional study conducted in Services Hospital Lahore from August 2016 to July 2018. Total of 150 patients were recruited in this study. Patients fulfilling inclusion criteria were assessed through complete history, proper examination, biochemical tests, ultrasonography and radiological and endoscopic tests (CECT of abdomen, MRI/MRCP, ERCP) if indicated. The data was recorded on a predesigned performa and SPSS software version 22 was used for statistically analysis. Results: In this study, the mean age of patients was 50.23+/-15.93 years. 56.7% were female and 43.3% were males. In the study, 54.67% had benign disease with choledocholithiasis being the most common cause and 45.33% had malignant disease with pancreatic carcinoma being the leading etiology. 67.33% patients underwent definitive surgery and 32.67% patients were treated with palliative procedures. Different definitive procedures carried out were whipple procedure (20%), cholecystectomy and CBD exploration (23.33%), ERCP followed by cholecystectomy (20%), excision of cyst and hepaticojejunostomy (5.3%), subtotal cholecystectomy (2.7%) patients, ERCP and stent placement (2.7%) and extended cholecystectomy (1.3%). Palliative procedure performed were PTBD (10%), palliative hepaticojejunostomy (6.67%), palliative cholecystojejunostomy (4.67%) and hepaticojejunostomy plus gastrojejunostomy (5.33%). 30 days mortality rate was 13.33% Conclusion: It is inferred that benign causes of obstructive jaundice are more prevalent than malignant causes and more patients underwent palliative surgeries in malignant etiology of obstructive jaundice.

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