title: Factors affecting post-operative mortality in malignant biliary tract obstruction.
abstract: OBJECTIVE
  Although malignant obstruction, itself, is a significant risk factor associated with post-operative mortality, factors affecting mortality in the surgery of malignant obstruction have not been thoroughly studied in the literature.
  
  
  METHODS
  In order to identify independent risk factors which might be associated with an increase in post-operative mortality in patients with malignant biliary obstruction, 24 clinical and laboratory parameters in 52 patients undergoing biliary tract surgery were analyzed retrospectively.
  
  
  RESULTS
  Simple regression revealed 24 factors with prognostic significance, but multivariate analysis detected only 3 factors with independent significance in predicting mortality (cholangitis, weight loss of 10 kg or more and operative or post-operative blood transfusion). The presence of 2 of these risk factors identified a group of patients with an 37% mortality rate.
  
  
  CONCLUSIONS
  The results of this study show that the presence of pre-operative cholangitis, marked weight loss, and operative and post-operative blood transfusion are associated with high post-operative mortality. The major challenge is the prevention of cholangitis in high-risk patients, improvement of the nutritional status of the patients, and avoidance of unnecessary blood transfusions.
authors.affiliation: 4th Department of Surgery, Ankara Numune Hospital, Turkey.
authors.forename: N A
authors.initials: NA
authors.lastname: Kama
authors.forename: T
authors.initials: T
authors.lastname: Coskun
authors.forename: Y N
authors.initials: YN
authors.lastname: Yuksek
authors.forename: A
authors.initials: A
authors.lastname: Yazgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D001803:Blood Transfusion; D018281:Cholangiocarcinoma / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000150:complications; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis