Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice

Department of Medicine, DHQ/RMC Hospital, Raja Bazar, Rawalpindi.
Journal of the College of Physicians and Surgeons--Pakistan: JCPSP (Impact Factor: 0.35). 07/2003; 13(6):325-8.
Source: PubMed


To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice.
A retrospective, observational study.
The study was carried out at Valley Clinic, Rawalpindi, from January 1999 to January 2002.
Two-hundred and twenty-six patients, who underwent ERCP for evaluation of obstructive jaundice were included. ERCP in each case was performed with standard technique and the findings were recorded. Therapeutic procedures like sphincterotomy, Dormia extraction for stone, and stent placements were performed whenever indicated.
Of the 226 patients, 117 (51.8%) were males, and 109 (48.2%) females, their mean age being 51.8+/-16.6 years. Common bile and pancreatic ducts were visualized in 81.8% and 68.1% patients respectively. Growth/masses and stones were commonest causes of obstructive jaundice. Choledocholithias was common in males, while biliary channel related growth/masses were common in females (p-value=0.03). Common bile duct stone clearance rate was 88%, stenting was highly successful in patients with growth and strictures. ERCP related complications were noted in 11 (4.8%) patients.
ERCP is an important diagnostic and therapeutic modality for evaluation of patients with obstructive jaundice. Growth/masses and stones are common causes of obstructive jaundice which can be diagnosed and treated with ERCP.

  • Source
    • "With ultrasound the cause of biliary duct obstruction, its degree and site can be determined in many cases of obstructive jaundice (Laing et al. 1986). Obstruction of the biliary duct is caused by gall stones, strictures, carcinoma of the gall bladder, cholangio-carcinoma, periampullary carcinoma and carcinoma of the head of the pancreas (Khurram et al. 2003). Also gray scale ultrasound was used successfully used to assess prostate pathologies and stones of the urinary system (Ahmed et al. 2015).Thusthe objective of the current investigation is to evaluate the effectiveness of trans-abdominal gray scale ultrasound in assessing the incidence of carcinoma of the head of the pancreas (CPH) among patients suffering obstructive jaundice. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Jaundiceis theprecipitation of bilirubin in the tissues of the skin, sclera and mucous membranes causing a yellowish staining.It is pre-hepatic, hepatic or post hepatic. The post hepatic form is usually caused by obstruction of the common bile duct (CBD). Carcinoma of the head of pancreas (CPH)is a major cause of CBDobstructionsince it passes posterior to the head of the pancreas. The objective of this study is toassessthe effectiveness of the gray scale ultrasound to differentiate and diagnose the causes of obstructive jaundicewith an emphasis on the obstructive jaundice caused by CPH. Furthermore the influences of age, gender and occupation on CPH obstructive jaundice were also evaluated. This study was carried at Ebn-Siena Specialized Hospital - Khartoum state – Sudan, from January 2013 till June 2014. One hundred patients who were initially diagnosed to have obstructive jaundice were included in this study. Patients were selected thorough a good history and clinical examination, followed by laboratory tests and confirmed with radiological methods (CT-, MRCP & ERCP). For the purpose of this study all patients were further scrutinized with advanced different types of gray scale ultrasound machines (Duplex Doppler machines) that can emit 2 to 5 MHz from a convex transducer. The results ofthe gray scale ultrasound revealed asignificantly high (p<0.001)incidence of obstructive jaundice caused by CPHcompared to other causes. The obstruction was either middle or distal and no proximal obstruction was recorded.The incidence of CPH obstructive jaundice significantly (p<0.001) increases with the increment of age. The most susceptible groupsare the age groups of ≥ 60 years (56.1%) and the age group of 40-59 years (39.0%). Gender did not influenced (p>0.05) the incidence of CPH obstructive jaundice. Among occupations housewives were highly (p<0.001) susceptible followed by farmers and free lancers ((p<0.03) compared to other occupations. In conclusion the non invasive gray scale ultrasound is an effective tool to diagnose and differentiate between the different causes of obstructive jaundice.Furthermore CPH causes high incidence of obstructive jaundice and elderly and housewives are more susceptible to this kind of obstructive jaundice. Key words: Ultrasound, cancer of pancreas head, obstructive jaundice, gender, age, occupation
    Full-text · Article · Aug 2015 · IOSR Journal of Dental and Medical Sciences
  • Source
    • "A vast array of invasive and non invasive diagnostic tests is available to diagnose and establish the etiology of surgical obstructive jaundice [4,7]. Invasive tests may cause cholangitis and imaging techniques like computed tomography (CT) scan, PTC, ERCP and MRCP are expensive and are not readily available in most centers in developing countries [7-10], and ultrasonography remains the only diagnostic test available [4,11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Obstructive jaundice poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. This study was undertaken to highlight the etiological spectrum, treatment outcome of obstructive jaundice in our setting and to identify prognostic factors for morbidity and mortality. This was a descriptive prospective study which was conducted at Bugando Medical Centre between July 2006 and June 2010. All patients with a clinical diagnosis of obstructive jaundice were, after informed consent for the study, consecutively enrolled into the study. Data were collected using a pre-tested structured questionnaire and analyzed using SPSS computer software version 11.5. A total of 116 patients were studied. Females outnumbered males by a ratio of 1.3:1. Patients with malignant obstructive jaundice were older than those of benign type. Ca head of pancreas was the commonest malignant cause of jaundice where as choledocholithiasis was the commonest benign cause. Abdominal ultrasound was the only diagnostic imaging done in all patients and revealed dilated intra and extra-hepatic ducts, common bile stones and abdominal masses in 56.2%, 78.9%, 58.1% and 72.4% of the cases respectively. A total of 110 (94.8%) patients underwent surgical treatment and the remaining 6 (5.2%) patients were unfit for surgery. The complication rate was 22.4% mainly surgical site infections. The mean hospital stay and mortality rate were 14.54 days and 15.5% respectively. A low haematocrit and presence of postoperative sepsis were the main predictors of the hospital stay (P < 0.001), whereas age > 60 years, prolonged duration of jaundice, malignant causes and presence of postoperative complications mainly sepsis significantly predicted mortality (P < 0.001). Obstructive jaundice in our setting is more prevalent in females and the cause is mostly malignant. The result of this study suggests that early diagnosis and treatment plays an important role in the prognosis of patients with obstructive jaundice.
    Full-text · Article · May 2011 · BMC Research Notes
  • Source

    Preview · Article · Jan 2004 · World Journal of Gastroenterology
Show more