Management of malignant obstructive jaundice at The Middlesex Hospital.
A total of 180 patients with malignant obstructive jaundice have been treated by 5 different methods: surgical resection; surgical by-pass; percutaneous prosthesis; endoscopic prosthesis; and endoscopic sphincterotomy (for papillary tumours). The spectrum of patients is unusual, because many elderly and ill patients were referred for nonoperative management. Operative by-pass, percutaneous and endoscopic prostheses gave similar overall results, with a mean survival of about 6 months. Patients with tumours of the papilla of Vater treated by endoscopy or surgery fared well; 11 of 18 were alive at follow-up. Median survival after resection of other tumours was 17 months. These results underline the need for randomized clinical trials, which are now in progress.
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery; D001661:Biliary Tract Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D019736:Prostheses and Implants