[Dose standardized management of patients with occlusive jaundice reduce morbidity and mortality?].
Patients with obstructive jaundice have a high incidence of complications. Invasive techniques required for definitive diagnosis and treatment compound the situation. In a prospective randomised trial we studied 54 patients over a 12-month period. All had obstructive jaundice (bilirubin greater than 100 mg/%). Prior to treatment, the trial protocol required correction of fluid balance (CVP), administration of albumin and vitamin K and an adequate urine output. Antibiotics were administered in accordance with a strict regime. The overall mortality was 7.5%, in elective cases with a mortality of 4%, in emergency cases with a mortality of 100%. The surgical treated patients had a higher incidence of complications than patients with interventional procedure, but not a higher mortality. Patients with obstructive jaundice will benefit from an adequate pre-treatment resuscitation and a standardised treatment policy after elimination of the obstruction.
Gilg
M
M
Klinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Glättli
A
A
Baer
H U
HU
Blumgart
L H
LH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002779:Cholestasis / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate
Ein standardisiertes Management von Patienten mit Verschlussikterus reduziert die Morbidität und Mortalität?